Clinical Features and the Outcome Evaluations of Keloid and Hypertrophic Scar Treatment with Triamcinolone Injection in Mekong Delta, Vietnam – A Cross-Sectional Study

Abstract

Lam Van Nguyen,1 Huy Quang Ly,1 Hau Thi Vo,1 Thao Thanh Pham,2 Nam Ky Nguyen,3 Thi Van Vo,4 Trung Quoc Phan,1 Phuong Thi Ngoc Tran,1 Hung Huynh Vinh Ly,5 Ha Thi Thao Mai1 1Department of Cosmetic Plastic Surgery, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam; 2Department of Dermato-Venereology, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam; 3Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam; 4Department of Pediatrics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, Vietnam; 5Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho, VietnamCorrespondence: Hung Huynh Vinh Ly, Department of Orthopedics, Faculty of Medicine, Can Tho University of Medicine and Pharmacy, No. 179, Nguyen Van Cu Street, An Khanh Ward, Ninh Kieu District, Can Tho, 900000, Vietnam, Email [email protected]: Excessive scarring is a common problem that can have significant cosmetic and psychological consequences for patients. Intralesional injection therapy, such as the use of triamcinolone, has emerged as an effective treatment option for hypertrophic scars. The objective of this study was to describe the morphological features of hypertrophic scars, categorize them, and evaluate the efficacy of triamcinolone injection therapy in treating these scars.Materials and Methods: A cross-sectional descriptive study of 80 patients with hypertrophic scars treated with triamcinolone intralesional injection at Can Tho University of Medicine and Pharmacy Hospital from 5/2018 to 5/2021.Results: There were 80 patients in all, with a male/female ratio of 1/1.05 and a median age of 15– 35. There were 129 scars in all, with scar age > 1 year accounting for 83%, keloid scars accounting for 64%, and hypertrophic scars accounting for the remaining 36%. Scars are most commonly seen on the trunk, accounting for 53.5% of all scars, particularly on the anterior chest wall. When the source of scars was discovered, trauma and acne accounted for 24% and 23%, respectively, while the rest were predominantly spontaneous scars, accounting for 49%. Scarring and discomfort of mild to moderate severity were common clinical symptoms; scars larger than 5cm in size had more symptoms than scars smaller than 5cm. Prior to the therapy, the mean Vancouver Score Scale-VSS was 6.55± 2.13. After 24 weeks of the therapy, 96.7% of patients had entirely improved itching symptoms, 75% had completely improved pain, and 25% still had minimal pain. After therapy, the mean Vancouver Score Scale-VSS was 2.55± 1.81 (p< 0.05). At week 24, 3.75% of patients experienced skin shrinkage, 3.75% experienced depigmentation, and 13.75% experienced vasodilation.Conclusion: Triamcinolone intralesional injection should be utilized as a first-line therapy for hypertrophic scarring.Plain Language Summary: This study looked at the effectiveness of triamcinolone injection (TAC) therapy in treating hypertrophic scars, which can cause significant cosmetic and psychological problems for patients. The study included 80 patients who had hypertrophic scars and were treated with triamcinolone injections over a period of 24 weeks. The majority of the scars were keloid scars (64%) and had an age of over one year (83%). Scars were most commonly found on the trunk, especially the anterior chest wall. The most common sources of scarring were trauma and acne. Mild to moderate scarring and discomfort were common symptoms, with larger scars having more symptoms. Before treatment, the mean Vancouver Score Scale-VSS was 6.55± 2.13. After 24 weeks of treatment, 96.7% of patients had improved itching symptoms, 75% had improved pain, and 25% still had minimal pain. The mean Vancouver Score Scale-VSS was also significantly reduced after treatment (2.55± 1.81). Some side effects were observed, such as skin shrinkage, depigmentation, and vasodilation, but these were experienced by a small percentage of patients. Based on these results, the study concludes that triamcinolone injection therapy should be considered as the first-line treatment for hypertrophic scarring. This therapy was found to be effective in reducing symptoms and the overall appearance of scars, with few side effects. This study provides valuable information for healthcare professionals who treat patients with hypertrophic scars, and may help improve the quality of life for those affected by this condition.Keywords: clinical features, hypertrophic scar, triamcinolone intralesional injection

Keywords

• clinical features
• hypertrophic scar
• triamcinolone intralesional injection