Comparison of Combined Pulsed Dye Laser and Intralesional Triamcinolone versus Intralesional Triamcinolone alone in Treatment of Keloid
Bibliographic record
Abstract
ackgroundKeloids are benign dermal fibroproliferative growths causing cosmetic disfigurement and physical disability. Various treatments exist, but no gold standard has been established.ObjectivesTo compare the effectiveness of pulsed dye laser combined with intralesional triamcinolone versus Intralesional triamcinolone alone in keloid treatment.Patients and MethodThis interventional, prospective study was conducted at Dermatology and Venereology center, Medical City Hospital, Baghdad, Iraq, from August 2021 to September 2022. Twenty-five patients participated. Ten patients had two keloid scars: one received pulsed dye laser with intralesional triamcinolone (Group A) and the other received only intralesional triamcinolone (Group B). The remaining fifteen patients had a single lesion divided into two halves: one half received pulsed dye laser with intralesional triamcinolone (Group A), and the other half received only intralesional triamcinolone (Group B).Laser parameters were (fluence 8 J/cm², spot size 7 mm, pulse duration 1.5 ms) or (fluence 5 J/cm², spot size 10 mm, pulse duration 0.45 ms). Triamcinolone acetonide concentration was 10-40 mg/ml. Each group received treatment at 0, 1, 2, and 3 months (four sessions). Follow-ups were conducted monthly for two months. Response was assessed using the Vancouver Scar Scale (VSS) and Patient Observer Scar Assessment Scale (POSAS).ResultsSignificant improvement in total VSS and POSAS scores was observed within each group between the first visit and the second follow-up visit (P=0.0001). There was a significant difference in mean total VSS at the second follow-up between Group A and Group B (P=0.005). The mean total observer score differed significantly between Group A and Group B at the second follow-up (P=0.031). However, there was no significant difference in the mean total patient score at the second follow-up between Group A and Group B (P=0.708).ConclusionIntralesional steroid is effective for keloid treatment, but its efficacy improves when combined with pulsed dye laser.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".