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TOPLINE:

A nonsurgical combination treatment for keloids achieved complete resolution in over 80% of patients and was associated with high satisfaction rates in an observational study of adults in Brazil with higher skin phenotypes.

METHODOLOGY:

• To evaluate a sequential nonsurgical approach to treating keloids, researchers conducted a longitudinal, retrospective observational study of 79 adults with Fitzpatrick phototypes ≥ III (mean age, 39.46 years; 78.5% women) with keloids who had completed their last treatment at least 19 months prior to the study.
• The patients received the Assessment, Softening, Application of technologies and antifibrotic drugs, Pigmentation (ASAP) protocol that involves occlusion with hydrocolloid dressings for ≥ 2 months, monthly injections of 5-fluorouracil (50 mg/mL) and triamcinolone hexacetonide (20 mg/mL) in a 1:1 proportion, and intense pulsed light sessions.
• The primary outcome was lesion resolution (via a five-point scale assessing erythema and flattening). Patient satisfaction and keloid recurrence were also measured.
• Patients underwent treatment for a median of 10 months and were followed-up for 19-123 months.

TAKEAWAY:

• Complete resolution was achieved in 65 (82.3%) patients, partial resolution was achieved in the remainder (17.7%), and one (1.3%) patient experienced keloid recurrence.
• Satisfaction rates among patients were high, with nearly 95% reporting maximum scores. Higher satisfaction rates were positively correlated with complete keloid resolution (P = .000176).
• Pain was reported in 8.9% of cases. Adverse effects were associated with a lower complete resolution rate (P = .019).
• The treatment duration (mean, 18.95 months) did not correlate with complete resolution (P = 1.00).

IN PRACTICE:

“The ASAP protocol represents a significant advancement in the treatment of keloids, delivering high patient satisfaction, low recurrence rates, and long-term outcomes,” the authors wrote. “By offering a nonsurgical, patient-friendly approach with enduring outcomes, the ASAP protocol provides valuable insights for dermatologists and policymakers to optimize keloid treatment practices, ultimately enhancing patient care and satisfaction.”

SOURCE:

The study was led by Marina Patrus Ananias de Souza Brandão, Medical Sciences Faculty of Minas Gerais, Belo Horizonte, Brazil, and was published online on May 5 in International Journal of Dermatology.

LIMITATIONS:

Limitations included the single-center design, lengthy treatment duration, and reliance on specialist expertise.

DISCLOSURES:

The study was supported by a scholarship from the Medical Sciences Faculty of Minas Gerais. The authors had no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.