Intralesional Steroid Injection versus Erbium Yttrium Aluminium Garnet Laser Assisted Topical Corticosteroid Delivery in Treatment of Keloids.

Keloid scars are often considered aesthetically unattractive and frustrating problem that cause functional and cosmetic deformities, displeasure, itching, pain, and psychological stress and may possibly affect joint movement (Trisliana et al., 2014).With limited knowledge about the actual causes of keloids, determining the most effective treatment has been challenging. Various methods have been implemented to improve keloid scars using both surgical and non-surgical approaches such as intralesional corticosteroid injections, fractional lasers, cryosurgery, 5-fluorouracil (5-FU), retinoic acid, imiquimod 5% cream (an immune response modifier that enhances healing, has also been used to help prevent keloid recurrence after surgical excision)., tamoxifen, tacrolimus, botulinum toxin, silicone sheets (Berman, 2017).Fractional lasers have emerged as a therapeutic option for the aesthetic restoration and functional enhancement of traumatic scars. They create zones of ablation at variable depths, which induce a molecular cascade, including heat shock proteins and other factors that lead to a rapid healing response and prolonged neocollagenesis with subsequent collagen remodeling. The likely result is the removal of a portion of fibrotic scar tissue and a relative normalization of collagen structure and composition (Cavalié et al., 2015).Aim of studyTo compare a combination treatment modality consisting of fractional ablative laser treatment and topical corticosteroid application to the standard modality of corticosteroid intralesional injection.