A comparative clinical study on role of 5-flurouracil versus triamcinolone in the treatment of keloids.

A wide range of therapies exist for keloids. But despite the multiple treatment modalities available, keloids still remain a significant challenge for both the clinician and the patient. To compare the efficacy of 5-flurouracil (5-FU) versus triamcinolone as a therapeutic agent for the treatment of keloids. A randomized control trial was carried out at a teaching hospital in Kolkata over a period 2.5 years. Forty-four patients took part in the study, 20 in group F and 24 in group T. The age ranged from 16 to 66 years. The mean age of group F was 34.7 ± 11.0124 years (range 16-66 years) and of group T was 32.96 ± 9.584 years (range 19-60 years). The difference in the age and sex between the two groups was comparable and not statistically significant (p = 0.096). The response was rated as excellent (76-100% decrease in volume), good (51-75%), fair (26-50%), and poor (less than 25%). The reduction in keloid volume was comparable in both the groups. But side effects were much more in group F compared to group T. About 95% of the patients in group F found the injection very painful. About 6% of the patients in group F presented soon after the first two to three sessions with superficial ulcerations at the injection site accompanied by mild discomfort and discharge. This side effect was not seen in group T. Regarding pain at the injection site and superficial ulceration, the difference between the two groups was found to be statistically significant (p < 0.05). The patients treated with 5-FU experienced side effects such as hyperpigmentation, pain at the injection site, and superficial ulceration, which were statistically highly significant. It appears from this study that triamcinolone is a better tolerated and less toxic alternative to 5-FU in the management of keloids.