Effect of triamcinolone in keloids morphological changes and cell apoptosis

OBJECTIVE:to assess the effects of injectable triamcinolone on keloid scars length, height and thickness, and on the number of cells undergoing apoptosis.METHODS:This study consists in a prospective, controlled, randomized, single-blinded clinical trial, conducted with fifteen patients with ear keloids divided into two groups: group 1 - seven patients undergoing keloid excisions, and group 2 - eight patients undergoing keloid excisions after three sessions of infiltration with one ml of Triamcinolone hexacetonide (20mg/ml) with three week intervals between them and between the last session and surgery. The two groups were homogeneous regarding age, gender and evolution of the keloid scar. The keloid scars of patients in group 2 were measured for the length, height and thickness before triamcinolone injection and before surgery. A blinded observer performed morphological detailing and quantification of cells in hematoxylin-eosin-stained surgical specimens. An apoptotic index was created.RESULTS: The apoptotic index in group 1 was 56.82, and in group 2, 68.55, showing no significant difference as for apoptosis (p=0.0971). The reduction in keloid dimensions in Group 2 was 10.12% in length (p=0.6598), 11.94% in height (p=0.4981) and 15.62% in thickness (p=0.4027).CONCLUSION:This study concluded that the infiltration of triamcinolone in keloid scars did not increase the number of apoptosit and did not reduce keloids' size, length, height or thickness.研究目的：评估注射用曲安奈德（triamcinolone）对瘢痕疙瘩（keloid）的长度、高度、厚度以及凋亡细胞数量的影响。 研究方法：本研究为一项前瞻性、对照、随机、单盲临床试验，纳入15例耳部瘢痕疙瘩患者，分为两组：组1共7例患者直接接受瘢痕疙瘩切除术；组2共8例患者先接受3次己酮曲安奈德（Triamcinolone hexacetonide）浸润注射，每次注射1ml（浓度20mg/ml），两次注射间隔为3周，末次注射与手术间隔亦为3周，再行瘢痕疙瘩切除术。两组患者在年龄、性别及瘢痕疙瘩病程方面均基线同质。组2患者的瘢痕疙瘩在曲安奈德注射前及手术前均测量了长度、高度与厚度。由一名盲法观察者对苏木精-伊红染色的手术标本进行形态学细节分析及细胞计数，并计算得到凋亡指数。 研究结果：组1的凋亡指数为56.82，组2为68.55，两组间凋亡细胞数量无统计学差异（p=0.0971）。组2瘢痕疙瘩的尺寸较基线缩减情况为：长度减少10.12%（p=0.6598）、高度减少11.94%（p=0.4981）、厚度减少15.62%（p=0.4027）。 研究结论：本研究表明，瘢痕疙瘩局部浸润注射曲安奈德，既未增加凋亡细胞数量，也未使瘢痕疙瘩的尺寸、长度、高度或厚度出现显著缩减。