Efficacy of intra lesional injection of 5-flourouracil on keloid scar: A prospective open clinical trial

Banoo Dhahir   Latif; Mohammed Yousif  Saeed; Darseem Muhammed  Abdulla

doi:10.56056/amj.2024.263

Authors

Banoo Dhahir Latif MCHB. Shahid Jabar Dermatological Teaching Center, Sulaimani Directorate of Health, Sulaimaniyah, Iraq,
Mohammed Yousif Saeed MBCHB, FIBMS. Asst. Prof. Department of Medicine, College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq,
Darseem Muhammed Abdulla MBCHB, FIBMS. Lecturer. Department of Medicine, College of Medicine, University of Sulaimani, Sulaimaniyah, Iraq

DOI:

https://doi.org/10.56056/amj.2024.263

Keywords:

Antineoplastic agent, Monotherapy, Prospective-clinical trial study, Skin disorder

Abstract

Background and objectives: The management of keloids stayed unsatisfactory. Intralesional 5-fluorouracil has not been broadly and intensively studied as a monotherapy in the treatment of keloids worldwide. So, the aim of this study was to evaluate the efficacy and safety of intralesional injection of 5-flourouracil in patients with keloids.

Methods: In this prospective clinical trial study, a total of 20 patients aged >18 years at Shahid Jabar Dermatological Teaching Center, Sulaimaniyah, Iraq, from January 2022 to August 2022 were enrolled. Patients were treated at 1-week interval with intralesional injection of 5-flurouracil (50 mg/mL) at maximum of 6 sessions. Average injection volume was 0.2 mL/cm². All patients were followed up for 6 months.

Results: Most of the patients were aged <50 years (90%) with no family history of keloid (75%). Additionally, 45% of patients had keloid in the trunk region with a size of ?10 cm²(65%). Most patients (80%) had the disease for ?5 years that caused by inflammation (55%), especially skin type IV (65%). After 6 sessions of treatment, 70% of patients showed moderate improvement, while 30% of patients showed minimum improvement. The main adverse effects after 6 sessions of treatment were hyperpigmentation in 3 patients, bullae in 2 patients, and tissue sloughing only in 1 patient. A significant correlation was found between the patient’s response and age/keloid location. Moreover, mean Redness, Elevation, Hardness, Itching, and Tenderness score after treatment was significantly lower than before treatment (p<0.001).

Conclusions: Our results concluded that 5-flurouracil is a safe and effective therapy for the treatment of keloids.

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