Intra-lesional Steroid Injections: Can they be harmful to some patients? Results of an online survey.

Abstract

Background: Intralesional Triamcinolone Acetonide (ILTA) is the most commonly used method of treating keloidal lesions. Although there are several reports about the efficacy of ILTA, there is a paucity of literature as to how keloid patients perceive the effectiveness of this treatment modality.

Objective: To assess patients’ perception about the efficacy of ILTA in treatment of keloidal lesions.

Material and methods: Underlying study was approved by the Institutional Review Board (IRB). The online survey was launched in November 2011. Participants were asked to report their perception of the efficacy of ILTA for treatment of their keloidal lesions. Descriptive statistics are provided.

Results: As of May 29, 2017, a total of 1477 consecutive individuals participated in the survey. 847 participants indicated that they had previously received at least one ILTA, among whom 808 patients provided an assessment of the efficacy of this intervention. Nine patients (1.1%) reported that ILTA cured their keloids. 263 patients (32.6%) reported having benefited from the treatment. 396 patients (49%) reported no improvements, but most interestingly, 140 patients (17.3%) reported that ILTA caused worsening of their keloids.

Conclusions and Relevance: With several limitations, this study represents the first step in developing a patient reported measure of treatment success and benefit drawn from ILTA. The most important finding of this study is that 17.3% of patients reported that worsening of their keloids with this treatment. Worsening of keloids after steroid injections has never been reported.