Treatment of an ear keloid refractory to intralesional triamcinolone injection monotherapy with fractional CO2 laser and triamcinolone combination therapy: a case report

Abstract

Keloid is a benign fibroproliferative disorder characterized by excessive collagen production during abnormal wound healing in keloid-prone individuals. Therefore, the treatment of keloid aims to reduce inflammation and reorganize collagen bundles. Intralesional corticosteroid injection, particularly triamcinolone, is a common first-line treatment, but injections can be difficult in very firm lesions. This case report presents a refractory ear keloid treated with a combination therapy of fractional ablative CO2 laser and intralesional triamcinolone injection. The patient had a persistent keloid mass in her left ear despite previous intralesional corticosteroid injections. The ear keloid was treated with the combination therapy of fractional CO2 laser and triamcinolone injection. The keloid size was reduced by more than 50%, and the Vancouver Scar Scale score improved. Combined fractional CO2 laser and triamcinolone injections may have a synergistic effect on drug delivery in addition to each keloid improvement.