IMPROVEMENT OF EFFICACY AND SAFETY PROFILE IN TREATING MULTIPLE ERUPTIVE KELOIDS USING COMBINATION OF ABLATIVE FRACTIONAL CARBON DIOXIDE (CO2) LASER AND INTRALESIONAL INJECTION OF STEROID SUSPENSION

Abstract

Keloid is a benign fibroproliferative disease caused by an abnormal response to skin injury, including trauma, acne vulgaris, chickenpox, and many others. In multiple eruptive keloids, many papules and plaques may form simultaneously over one or more anatomical regions causing a disfiguring look. Keloids are also recalcitrant to treatment and tend to recur many times, especially with monotherapy. Intralesional injection of steroid suspension has been the first‐line therapy for many years due to its ability to inhibit fibroblast growth and induce collagen breakdown but require multiple treatments and can result in skin atrophy, telangiectasia, pigmentary changes, and systemic effects such as Cushing's syndrome. The risk of complications is even greater when high cumulative dosages are used in multiple keloid lesions. With the dawn of Laser technology, ablative fractional carbon dioxide laser is an encouraging new option with the ability to modulate cellular growth factors to prevent excessive formation of collagen bundles. However, the ablative fractional Laser still requires many treatments with a high recurrence rate. In this case series, we seek to improve the efficacy and safety of the treatment of eruptive keloid by S46 | 10969101, 2022, S34, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/lsm.23536 by INASP/HINARI - INDONESIA, Wiley Online Library on [07/11/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License combining intralesional steroid suspension injections with ablative fractional carbon dioxide (CO2) laser. Study Design/Materials and Method: Five patients with eruptive keloids on the chest were treated using a combination of ablative fractional CO2 laser and intralesional injections of steroid suspension. Both Laser procedures and injections were done every 4 weeks for 12 weeks. Clinical follow‐up was focused on the total number of lesions and the volume of each keloid lesion.