Table 8.
Other treatment modalities
| First author, year | Study design | Treatment | Duration | N | Outcome(s) | Follow-up time | Adverse events | Comments |
|---|---|---|---|---|---|---|---|---|
| Berman, 2013 [124] | P | Excision then porcine gelatin-dextran hydrogel scaffold | NA | 19 (26 keloids) | 7.7% recurrence rate, average patient scar satisfaction 9.9/10 | 12 months | None | Earlobe keloids |
| Bhusari, 2017 [122] | P | Re-188 custom RT patch | 3 h on weeks 1 and 3 | 12 (85 keloids) | Durable symptomatic relief, scar size, and elevation reduced for all | 12 months | Ulceration, hypopigmentation | No objective measurements reported |
| Garakaparthi, 2016 [125] | P | Excision then hydrogel scaffold | NA | 19 (26 keloids) | 19.2% recurrence rate | 12 months | Earlobe keloids | |
| Kim, 2020 [120] | RCT | IL TAC and extracorporeal shockwave therapy (ESWT) vs IL TAC alone | 4 sessions of Q3 week IL TAC then ESWT weekly for 10 sessions vs 4 sessions of q3 week IL TAC | 40 | Mean VSS 7.5 to 3.30 vs 6.85 to 4.1 | 12 weeks | Telangiectasia, hypopigmentation, atrophy, crystal formation (no difference between groups) | |
| Limthanakul, 2020 [126] | RCT | Excision then IL TAC (10 mg/ml) versus excision then topical 5% imiquimod cream | IL TAC until scar flattened vs qod for 12 weeks | 30 | Recurrence 50% versus 21.43%; no significant difference in VSS or patient satisfaction | > 12 months | Itching with imiquimod | Earlobe keloids |
| Salunke, 2014 [127] | RCT | Ksharsutra ligation vs ksharsutra ligation with agnikarma (cauterization) | NA vs agnikarma on day 3 after keloid removal | 20 | 70% vs 10% recurrence | 36 months | Ear pinna keloids, ksharsutra is surgical thread coated with latex of Euphorbia neriifolia and Curcuma longa powder | |
| Sigler, 2010 [128] | P | 2-mg colchicine daily then excision | 1 month prior until 1 year after excision | 10 | No recurrence | 2 years | Diarrhea necessitating dose reduction to 1 mg | |
| Song, 2018 [129] | RCT | Excision, RT, then hyperbaric oxygen therapy (HBOT) vs excision and RT | 900-cGy RT on days 1 and 7; HBOT 120 min daily for 2 weeks | 240 | 5.97% vs 14.15% recurrence (p < 0.5), 88.81% vs 75.47% fully cured | Median 20.5 vs 21 months | Not stated | |
| Tan, 2018 [121] | SB, P, intraindividual controlled | Drug-free solid microneedle array (MNA) vs no treatment | 4 weeks of treatment | 28 | Transient decrease in volume, no difference in VSS between treated and untreated | 8 weeks | Not stated | 1 patient did not participate; volume decreased after treatment but increased 4 weeks after treatment stopped |
| Wang, 2018 [119] | RCT | ESWT vs IL TAC (10 mg/ml) | 3 sessions ESWT in 6 weeks vs IL TAC q2 weeks for 3 sessions | 39 | Reduction in volume, height, appearance without significant difference between treatments | 48 weeks | Not stated | |
| Weshay, 2015 [123] | p | 3–4 sessions of RF then IL TAC (10 mg/mL) | IL TAC q3 months for 3 sessions and once after another 6 months | 18 | Volume reduction 95.4% (p = 0.001); 10% recurrence which resolved with IL TAC | 5 years | No infection |
P prospective trial, SB single blind, RCT randomized controlled trial, IL intralesional, TAC triamcinolone acetonide, qn every n, ESWT extracorporeal shockwave therapy, RT radiotherapy, RF radiofrequency, MNA microneedle array, HBOT hyperbaric oxygen therapy