Comparison of the Efficacy of Combined Intralesional Steroid and Cryotherapy Versus Intralesional Steroid Alone in the Treatment of Keloid

OBJECTIVE: To compare the efficacy of combined intralesional triamcinolone acetonide (IL TAC) and cryotherapy versus IL TAC alone in the treatment of keloid. STUDY DESIGN: Randomised controlled trial. Place and Duration of the Study: Department of Dermatology, PNS Shifa, Karachi, Pakistan, from July 2024 to February 2025. METHODOLOGY: Patients with keloids were randomly divided into two groups, with 38 patients in each group. Group A received a combination of IL TAC and cryotherapy, while Group B received IL TAC alone. Both treatments were administered three times at 4-weekly intervals. Keloids were assessed using photographic record, the Vancouver Scar Scale (VSS), and the Patients Scar Assessment Scale (PSAS). Treatment efficacy was defined as a >75% reduction in the VSS score from baseline at the end of the treatment. Repeated measure ANOVA was used to compare the VSS score and the PSAS score within the groups, whereas the independent t-test was applied to compare the scores between the two groups. The Chi-square test was used to compare efficacy between the two groups. RESULTS: Most patients were young males, and keloids were most commonly observed on the chest. IL TAC alone was effective in 23 patients (60.5%), while the combination of IL TAC and cryotherapy was effective in 31 patients (81.5%). The difference was statistically significant (p = 0.038). Patient satisfaction was also higher in the combination therapy group. CONCLUSION: IL TAC combined with cryotherapy is more efficacious than IL TAC alone in the treatment of keloid, resulting in higher level of patient satisfaction. KEY WORDS: Cryotherapy, Combination treatment, Efficacy, Intralesional triamcinolone acetonide, Intralesional steroid, Keloids.