In Search of the Optimal Treatment of Keloids: Report of a Series and a Review of the Literature

The optimal treatment for keloids remains undefined. A randomized, prospective study was performed comparing two treatment regimens that were believed promising. One regimen consisted of surgery plus two preoperative and three postoperative intralesional injections of triamcinolone, whereas the other regimen consisted of surgery plus oral colchicine (1.2 mg per day) initiated 3 weeks after surgery and continued for 5 months. The study was compromised by limited acceptance of the experimental protocol, though many patients were willing to accept one of the regimens on a nonprotocol basis. Data from protocol and nonprotocol patients were pooled to allow for an adequate number of patients for analysis. Minimum follow-up required for inclusion in the analysis was 1 year. A total of 27 keloids in 16 patients were treated with surgery and adjunctive triamcinolone, and 28 keloids in 20 patients were treated with surgery and postoperative colchicine. Fifty (91%) of the keloids were on the ear. There were no significant differences between the two treatment groups in terms of sex, race, age, keloid location, keloid size, the duration the keloid was present, and the percentage of keloids that were recurrent. Only 8 (30%) of the keloids treated with surgery and perioperative triamcinolone were cured, whereas 9 (32%) of the keloids treated with surgery and postoperative colchicine did not recur. There was no significant difference between the two regimens.