ABSTRACT
BACKGROUND: Surgical management of keloids has been performed by either intralesional or extralesional excision. There has been no consensus regarding the optimal treatment for reducing recurrence and complications. We undertook this study to compare the outcomes of patients managed with intralesional or extralesional excisions followed by post excision radiation therapy.
OBJECTIVE: This was a comparative study to determine the outcome of keloids managed with intralesional vs. extralesional excision followed by post excision superficial radiation therapy.
RESULTS: A total of 90 patients with 104 keloids were treated in a prospective study. Duration of the study was two and half years. A total of 56 keloid lesions were excised by intralesional (IL) and 58 keloids by extralesional (EL) methods. The post-operative pruritus score after two year of follow-up was 1.98 in the IL group and 1.86 in the EL group. (P-value>0.05). Pain score was at 2.8 and 1.129 in the EL and IL respectively (P-value >0.05). The recurrence rate was 21% in the IL group and 18.9% in the EL group (P value >0.05). Overall patients’ satisfaction was good in both groups.
CONCLUSION: There was no difference in the outcome of keloids excised with either method. We concluded that both methods can be utilized in excising keloid lesions. Further research should be conducted to evaluate the potential value of other adjuvant therapies such as steroids and cytotoxic agents.