Case series of combination of carbon dioxide laser and topical 5-flourouracil for prevention of recurrence of keloid

Abstract

The treatment of keloid has been a challenge, and at times, frustrating because of the recurrence. Hence, it is essential to find treatment modality with least recurrence and good cosmetic results. This study showed the effect of topical 5-fluorouracil following carbon dioxide (CO₂) laser excision on recurrence of keloid. Case series of Total 24 patients (20 females and 4 males) of age group 12-56 years having keloid of duration 1-8 years were included in this study. Lesions were present on ear lobes, shoulder, chest, leg. CO₂ laser was used in continuous mode to excise the lesions and all patients advised topical 5-FU (5%) once daily application over the lesion in the night, once re-epithelization started, for 4 weeks. The patients were followed up initially at every week for 4 weeks then every 4 weeks for 24 weeks to evaluate the response of treatment.  Of the 24 patients evaluated at 24 weeks, none (0%) showed any sign of recurrence. Out of 22 patients four (18.2%) patients complained of burning sensation/irritation. Three (13.6%) patients of erythema and erosion which cleared with temporary discontinuation of topical 5-FU and completed the 4 weeks of topical therapy. Three (13.6%) patients developed hypopigmentation.  Though response of this combination is encouraging in prevention of recurrence of keloid, recurrence on long term follow up need to be observed.