Auricular keloid management in Asian skin: Clinical outcome of intralesional excision and postoperative triamcinolone acetonide intralesional injection

• DOI: 10.1111/jocd.13383
• Publication Date: 2020-04-17T06:45:38Z
• Authors: Young‐Jun Choi; Yun Ho Lee; Heun Joo Lee; Ga‐Young Lee; Won‐Serk Kim
• Keywords: Adult; Male; Injections, Intralesional; Combined Modality Therapy; Triamcinolone Acetonide; 3. Good health; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Keloid; Humans; Female; Skin

AbstractBackgroundVarious options such as surgical excision, steroid injection, cryotherapy, pressure dressing, and radiation therapy are available for the treatment of auricular keloids. In particular, auricular keloid therapy using surgical excision is important because recurrence rates are low compared with keloids occurring in other parts of the body.AimsWe aimed to evaluate the clinical outcomes of intralesional excision followed by postoperative triamcinolone acetonide intralesional injection (TA ILI) as auricular keloid treatments.MethodsWe conducted a surgery records and chart review of patients who underwent auricular keloid treatment with intralesional excision and TA ILI. Reduction in height and volume was assessed by two blinded dermatologists. We also analyzed the recurrence rate over a 2‐year period and evaluated patient satisfaction using an 11‐point questionnaire (0‐10).ResultsEighteen Korean patients (2 males and 16 females) with a mean age of 26.5 years and a total of 20 lesions were evaluated. Lesion types by descending frequency were lobular (n = 10, 50%), anterior/posterior button (n = 3, 15%), wrap‐around (n = 3, 15%), dumbbell (n = 2, 10%), and sessile (n = 2, 10%). The total recurrence rate was 5% (1/20) within the 24‐month follow‐up period. Significant reduction (> 50%) in height and volume was achieved in 95% of patients. No serious or persistent adverse events were reported during the follow‐up period.ConclusionWe confirmed that TA ILI after intralesional excision can be effective for auricular keloid management. A low recurrence rate similar to that of postoperative radiation therapy was obtained with an effective surgical procedure and minimal postoperative treatment.