Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jun;13(6):3607-3612.
doi: 10.3892/etm.2017.4438. Epub 2017 May 8.

Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars

Xiao-E Chen  1   2 , Juan Liu  1 , Afzaal Ahmed Bin Jameel  1 , Maya Valeska  1 , Jia-An Zhang  1 , Yang Xu  1 , Xing-Wu Liu  2 , Hong Zhou  2 , Dan Luo  1 , Bing-Rong Zhou  1
Affiliations

Combined effects of long-pulsed neodymium-yttrium-aluminum-garnet laser, diprospan and 5-fluorouracil in the treatment of keloid scars

Xiao-E Chen et al. Exp Ther Med. 2017 Jun.

Abstract

Keloids are benign tumors that originate from scar tissues, but they usually overgrow beyond the original wounds. In a three-month single-center clinical trial, 69 patients were randomly divided into three groups. Patients in group 1 were treated with intralesional injection of diprospan (2 mg betamethasone disodium phosphate and 5 mg betamethasone dipropionate in 1 ml) with one-month intervals for three months. Patients in groups 2 and 3 were injected with a combination of 0.5 ml 5-fluorouracil (5-FU; 25 mg/ml) and diprospan as above for three months also. Prior to each injection, the keloids of patients in group 3 were additionally irradiated by a 1,064-nm neodymium-yttrium-aluminum-garnet (Nd:YAG) laser with a single pulse at an energy density of 90-100 J/cm2 and a pulse width of 12 msec. Clinical responses were evaluated by patient self-assessment and overall assessment by an observer according to the clinical signs of erythema, pruritus and pliability. A total of sixty-two patients completed the tests of the present study. At 2 and 3 months, the patients in all treatment groups showed an acceptable improvement in nearly all measurements. At the end of the study, the erythema and toughness score was significantly reduced and itch reduction was significantly greater in the diprospan + 5-FU + Nd:YAG group when compared to those in the other groups (P<0.05 for all indexes). The acceptable responses (good to excellent improvements) reported by blinded observers were as follows: 12% in the diprospan group, 48% in the diprospan + 5-FU group and 69% in the diprospan + 5-FU + Nd:YAG group. All of the results indicated that the combination of diprospan + 5-FU + Nd:YAG was the most efficacious therapy for keloid scars.

Keywords: 5-fluorouracil; diprospan; keloid; neodymium-yttrium-alumin-um-garnet laser; treatment.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Representative images of keloid scars at baseline and after three months of treatment. Keloid scar from a patient from the diprospan group (A) at baseline and (B) after treatment, a patient from the diprospan + 5-FU group (C) at baseline and (D) after treatment, and a patient from the diprospan + 5-FU + neodymium-yttrium-aluminum-garnet laser group (E) at baseline and (F) after treatment. 5-FU, 5-fluorouracil.
Figure 2.
Figure 2.
Response of keloid scars to the treatments at 3 months, as determined by patient self-assessment. 5-FU, 5-fluorouracil; Nd:YAG, neodymium-yttrium-aluminum-garnet laser.
Figure 3.
Figure 3.
Response of keloid scars to the treatments at 3 months, as determined by a blinded observer. 5-FU, 5-fluorouracil; Nd:YAG, neodymium-yttrium-aluminum-garnet laser.
Figure 4.
Figure 4.
Effect of the keloid scar treatments on erythema in the three groups. *P<0.05. 5-FU, 5-fluorouracil; Nd:YAG, neodymium-yttrium-aluminum-garnet laser.
Figure 5.
Figure 5.
Effect of the treatments on keloid scar toughness in the three groups. *P<0.05. 5-FU, 5-fluorouracil; Nd:YAG, neodymium-yttrium-aluminum-garnet laser.
Figure 6.
Figure 6.
Effect of the treatments on pliability of treated keloid scars in the three groups. *P<0.05. 5-FU, 5-fluorouracil; Nd:YAG, neodymium-yttrium-aluminum-garnet laser.
See this image and copyright information in PMC

References

    1. Shaffer JJ, Taylor SC, Cook-Bolden F. Keloidal scars: A review with a critical look at therapeutic options. J Am Acad Dermatol. 2002;46(2 Suppl Understanding):S63–S97. doi: 10.1067/mjd.2002.120788. - DOI - PubMed
    1. Shockman S, Paghdal KV, Cohen G. Medical and surgical management of keloids: A review. J Drugs Dermatol. 2010;9:1249–1257. - PubMed
    1. Wolfram D, Tzankov A, Pülzl P, Piza-Katzer H. Hypertrophic scars and keloids-a review of their pathophysiology, risk factors and therapeutic management. Dermatol Surg. 2009;35:171–181. doi: 10.1111/j.1524-4725.2008.34406.x. - DOI - PubMed
    1. Koike S, Akaishi S, Nagashima Y, Dohi T, Hyakusoku H, Ogawa R. Nd:YAG Laser treatment for keloids and hypertrophic scars: An analysis of 102 cases. Plast Reconstr Surg Glob Open. 2014;2:e272. doi: 10.1097/GOX.0000000000000231. - DOI - PMC - PubMed
    1. Kumar K, Kapoor BS, Rai P, Shukla HS. In-situ irradiation of keloid scars with Nd:YAG laser. J Wound Care. 2000;9:213–215. doi: 10.12968/jowc.2000.9.5.25985. - DOI - PubMed