Effective treatment of refractory auricular keloids with combined intralesional triamcinolone/5-FU and CO2 laser surgery: A case series

Introduction: Auricular keloids are benign yet cosmetically and symptomatically burdensome lesions with high recurrence rates following standard surgical treatment. Current evidence suggests that combination therapies may offer improved outcomes over monotherapy. Material and methods: This article presents a case series of three patients with recurrent auricular keloids, each previously treated with surgical excision alone. All patients underwent a standardized multimodal protocol involving intralesional injections of triamcinolone acetonide (TAC) and 5-fluorouracil (5-FU), followed by CO2 laser excision. Injections were continued postoperatively based on clinical evaluation. Results: All three patients demonstrated marked improvement in symptoms, including resolution of pruritus and pain, as well as significant lesion softening. No recurrences were observed during the follow-up period after the combined treatment. The protocol was well tolerated, with no adverse events reported. Conclusions: This case series supports the effectiveness of a multimodal treatment strategy using TAC, 5-FU, and CO2 laser excision for managing recurrent auricular keloids. The approach appears to reduce symptom burden and recurrence risk, offering a promising alternative for treatment-resistant cases. Further controlled studies are needed to validate these findings.