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Register a new userEffectiveness of Localized Injection of Botulinum Toxin versus Localized Injection of Steroids (Triamcinolone) in the Treatment of Keloids
فعالية الحقن الموضعي بالذيفان الوشيقي مقابل الحقن الموضعي للستيروئيد (TRIAMCINOLONE) في علاج الجدرات
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Tishreen University ورقة بحثية
Publication date
2020
fields
Medicine
and research's language is
العربية
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Shamra Editor
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أهمية وهدف البحث: تشكل الجدرات مشاكل جمالية ووظيفية, إضافة لترافقها مع أعراض سريرية مزعجة كالحكة والألم, وإن طرق العلاج الحالية محدودة الفعالية وغير مرضية في بعض الأحيان. تشير الدراسات السريرية إلى أن الذيفان الوشيقي (BTA) قد يمنع تشكل الجدرات ويعالجها, لذا كان الهدف من هذا البحث مقارنة فعالية الحقن الموضعي للذيفان الوشيقي مقابل الحقن الموضعي للستيروئيد في علاج الجدرات. طرائق البحث: شملت عينة البحث 23 مريضاً من مراجعي عيادة الأمراض الجلدية في مشفى تشرين الجامعي في اللاذقية بين عامي 2019 و2020 والمصابين بالجدرات, بلغ عدد الجدرات المسجلة لدى عينة البحث المدروسة 30 وزّعت على مجموعتين: المجموعة A تلقت العلاج بالحقن الموضعي للستيروئيد بمعدل جلسة كل 4 أسابيع على 6 جلسات, والمجموعة B تلقت العلاج بالحقن الموضعي للذيفان الوشيقي بمعدل جلسة كل 8 أسابيع على 3 جلسات. تم تقييم معايير موضوعية (القساوة, الارتفاع, الاحمرار, التصبغ), ومعايير شخصية (الحكة والألم) قبل وبعد العلاج, كما تم تقييم الآثار الجانبية. النتائج: كان هناك انخفاض بنسبة 58.4% في مقياس فانكوفر للمجموعة A, وبنسبة 65.8% للمجموعة B, دون فرق احصائي بين المجموعتين (P<0.05). انخفاض ملحوظ في درجة القساوة 85.9% في مجموعة العلاج A و82.7% في مجموعة العلاج B. وجد انخفاض ملحوظ في الارتفاع لدى A بنسبة 79.4% بينما لدى B حصل انخفاض بسيط بنسبة 27% مع وجود فارق ذو أهمية إحصائية لمجموعتي العلاج (P<0.05). بالنسبة للتوعية لاحظنا انخفاض بسيط في مجموعة العلاج A 17.7% وبدون أهمية إحصائية, بينما في مجموعة العلاج B حصل انخفاض بنسبة 58%. تبين أن تحسن الحكة في مجموعة العلاج B أكبر مع وجود فروقات ذات دلالة إحصائية (P<0.05). حدثت التوسعات الشعرية والضمور عند 11 مريض من المجموعة A. الخلاصة: أظهرت هذه الدراسة فعالية وأمان الحقن الموضعي للذيفان الوشيقي في علاج الجدرات من خلال تحسن المعايير الموضوعية والشخصية عند مقارنتها مع الحقن الموضعي للستيروئيدات القشرية. مع تسجيل آثار جانبية أقل للحقن الموضعي للذيفان.
Objective: Keloid pose aesthetic and functional problems, in addition to being associated with disturbing clinical symptoms such as itching and pain, and current methods of treatment are limited in effectiveness. Clinical studies indicate that botulinum toxin (BTA) may prevent the formation of keloid and treat it, so the aim of this research was to compare the effectiveness of topical injection of botulinum toxin versus topical steroid injection in the treatment of keloid. Methods: The research sample included 23 patients from the dermatology clinic at Tishreen University Hospital in Lattakia between 2019 and 2020, with keloids. The number of keloids registered with the studied sample was 30 distributed to two groups: Group A receiving IL steroid repeated every 4 weeks for six sessions, Group B IL BTA 5 IU /cm3 repeated every 8 weeks for three sessions. Objective parameters (hardness, elevation, pigmentation and vasscularity), subjective complaints (itching, pain, and tenderness), patient satisfaction, and side effects were evaluated. Results: There was a 58.4% decrease in the Vancouver scale for group A, and 65.8% for group B, without a statistical difference between the two groups (P <0.05). A noticeable decrease in tenderness 85.9% in treatment group A and 82.7% in treatment group B. A significant decrease in elevation in A 79.4% while B had a slight decrease of 27%. For vascularity we observed a slight decrease in treatment group A of 17.7% without statistical significance, whereas in treatment group B there was a decrease of 58%. The itching improvement in treatment group B was shown to be greater with statistically significant differences (P<0.05). Skin atrophy and telangiectasia were evident in 11 patients of group A. Conclusions: This study showed the efficacy and safety of topical toxin injection in treating keloid by improving objective and subjective criteria when compared to topical injection of corticosteroids. With fewer side effects reported for botulinum toxin.
References used
Sh aarawy, E., Hegazy, R. A., & Abdel Hay, R. M. (2015). Intralesional botulinum toxin type A equally effective and better tolerated than intralesional steroid in the treatment of keloids: a randomized controlled trial. Journal of Cosmetic Dermatology, 14 (2), 161 – 166.
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