Comparison of efficacy and safety of intralesional verapamil hydrochloride and intralesional triamcinolone acetonide in the treatment of keloids

Authors

  • Abdullah Adil Department of Dermatology Unit II, KEMU/ Mayo Hospital, Lahore
  • Saima Ilyas
  • Rutaba Kiran Department of Dermatology Unit II, KEMU/ Mayo Hospital, Lahore
  • Wajieha Saeed Department of Dermatology Unit II, KEMU/ Mayo Hospital, Lahore
  • Shahbaz Aman Department of Dermatology Unit II, KEMU/ Mayo Hospital, Lahore
  • Tahir Jamil Department of Dermatology Unit II, KEMU/ Mayo Hospital, Lahore

Keywords:

Efficacy, Safety, Verapamil, Keloids, Triamcinolone acetonide

Abstract

Objective The purpose of this study was to evaluate the effectiveness and safety of intralesional verapamil hydrochloride versus intralesional triamcinolone acetonide for the treatment of keloids.   Methods Total 88 (44 in each group) patients were enrolled. Group A (44 patients) was treated with intralesional verapamil hydrochloride (2.5mg/ml) through an insulin syringe. Group B (44 patients) was treated with 0.1ml/cm2 intralesional triamcinolone acetonide (20mg/ml). In both groups, site of lesion was draped with alcohol solution. The patients were treated every two weeks for 10 sessions or until the resolution of keloid. Response to treatment was assessed by VSS score by two blinded qualified dermatologists at 2-weeks follow up visit and inter-observer agreement was calculated. Follow up was done one month after the last treatment session and percentage reduction in VSS score from baseline was calculated and efficacy was assessed.   Results In intralesional verapamil group, the mean age of the patients was 34.93±12.42 years and in intralesional triamcinolone group, the mean age of the patients was 34.45±11.80 years. In intralesional verapamil group 25(56.8%) patients were male and in intralesional triamcinolone group, 24(54.5%) patients were male. At baseline; the mean VSS was 8.98±1.66 with intralesional verapamil, and 9.52±1.21 with intralesional triamcinolone (p-value=0.082). At the 18th week; the mean VSS was 5.68±1.58 vs. 4.91±0.83 (p-value=0.006). After 4 weeks of cessation of trial drugs, the mean VSS was 3.7±1.60 vs. 1.73±1.04, respectively (p-value=0.000). In intralesional verapamil group, the mean percentage reduction was 64.24±15.72% and in intralesional triamcinolone group it was 82.34±10.46%, p-value<0.001. In intralesional verapamil group, efficacy was noted in 10(22.7%) patients and in 28(63.6%) patients in intralesional triamcinolone group (p-value=<0.001). No side effects were observed with intralesional verapamil and with intralesional triamcinolone, side effects were absent in 26(60.5%) patients, p-value=<0.001.   Conclusion Intralesional triamcinolone acetonide is significantly more efficacious as compared to Intralesional verapamil hydrochloride for the treatment of keloids; however, intralesional verapamil hydrochloride is safer.  

References

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Published

2024-05-06

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1.
Adil A, Saima Ilyas, Kiran R, Saeed W, Aman S, Jamil T. Comparison of efficacy and safety of intralesional verapamil hydrochloride and intralesional triamcinolone acetonide in the treatment of keloids. J Pak Assoc Dermatol [Internet]. 2024May6 [cited 2024Nov.3];34(1):31-9. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/2574

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