Enhanced Scar Reduction With Triamcinolone Acetonide and Botulinum Toxin A Combination Therapy Compared to Botulinum Toxin A Monotherapy: A Translational Pilot Study
Bibliographic record
Abstract
BACKGROUND: The efficacy of combining triamcinolone acetonide (TAC) and botulinum toxin type A (BTX-A) to treat hypertrophic scars and keloids remains unclear. OBJECTIVES: This pilot study aimed to compare the clinical efficacy of BTX-A monotherapy and TAC + BTX-A combination therapy in improving scar conditions and to investigate potential mechanisms with a rat burn scar model. METHODS: This study was conducted between March 2022 and December 2024. Each patient's scar was randomly divided into 2 equal parts, with 1 part receiving TAC + BTX-A and the other BTX-A alone for 3 sessions at 4-week intervals. Scar thickness was measured with calipers, and the Vancouver Scar Scale (VSS) was administered to assess scar condition. Pain and pruritus were evaluated with a numeric rating scale (NRS) and visual analog scale (VAS), respectively, before each intervention (V1, V2, V3) and 4 weeks after the last session (V4). In the animal study, rats with burn scars were assigned to 5 groups: sham, untreated burn, TAC, BTX-A, and TAC + BTX-A. Scar thickness and expressions of alpha smooth muscle actin (α-SMA), transforming growth factor beta (TGF-β), connective tissue growth factor (CTGF), collagen I/III, laminin, and fibronectin were analyzed histologically. RESULTS: Clinically, both therapies reduced scar thickness, VSS, NRS, and VAS scores. However, combination therapy showed superior reductions in scar thickness (V2-V4) and VSS scores (V3, V4) compared to BTX-A monotherapy. No significant differences were observed in NRS and VAS scores. The animal study confirmed that combination therapy more effectively reduced scar thickness, TGF-β and CTGF levels, and the collagen I/III ratio, and increased the laminin/fibronectin ratio. CONCLUSIONS: TAC + BTX-A combination therapy enhances scar reduction by more effectively suppressing fibroblast proliferation and activation through TGF-β and CTGF downregulation, promoting scar remodeling.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".