Table 2.
Studies involving intralesional 5-FU monotherapy or intralesional 5-FU with corticosteroid adjunct therapy in the treatment of HTSs and keloids [15, 17–29]
| Author | Lesion type | Conc. 5-FU/TAC (mg/ml) | Max. dose/inj. (mg) | No. of inj. | Freq. | Follow-up (months) | Clinical improvement (% of pts.) | Reoccur. (no. of pts.) | SE (% of pts.) | Level of evidence | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Intralesional 5-FU monotherapy | Gupta and Kalra [17] | Keloids | 50/– | 150 | 16 | Once weekly | 3–6 |
33.3% excellent 25% good 16.6% poor 25% fair flattening |
0 |
Pain (100) PIH (100) Ulcer (2.6) |
IV |
| Nanda and Reddy [18] | Keloids | 50/– | 100 | 12 | Once weekly | 6 |
7.1% excellent 71.4% good 14.3% fair 7.1% poor 0% no improvement |
0 |
Pain (100) Ulcer (21.4) Burning (7.1) |
II | |
| Kontochristopoulus et al. [19] | Keloids | 50/– | 100 | 7 (mean) | Once weekly | 6 |
5% excellent 40% good 40% fair, 10% poor 5% no improvement |
9 |
Pain (100) PIH (100) Ulcer (30) |
IV | |
| Goldan et al. [20] | HTSs, keloids | 50/– | NR | 6 | Every 2 weeks | 3 | Good-excellent improvement | 0 | Pain (100) | IV | |
| Haurani et al. [21] | HTSs, keloids | 50/–a | 50 | 10 | Every 2–4 weeks | 12 |
63% complete, 27% partial, 10% no improvementb 34% complete, 52% partial, 14% no improvementc |
6 | NR | II | |
| Saha and Mukhopadhyay [22] | Keloids | 50/– | 100 | 5 (mean) | Once weekly | 12 |
10% excellent 55% good 20% fair 15% poor 0% no flattening |
6 |
Pain (95) PIH (90) Ulcer (65) |
II | |
| Khare and Patil [23] | Keloids | NR/–a | 150 | 2 | NA | >6 | 96% excellent | 1 |
Sup. necrosis (10.7) Dehiscence (7.1) Infection (3.6) |
IV | |
| Prabhu et al. [24] | Keloids | 50/– | 100 | 4 | Once weekly | 6 |
14% excellent 50% good 36% fair 0% none-poor flattening |
NR |
Pain (7) Pruritus (7) Ulcer (7) |
II | |
| Intralesional 5-FU + corticosteroid injections | Fitzpatrick [15] | HTSs, keloids | 45:1 | 100 | 1–25 | 1–3 per week | NR | Good-excellent improvement | NRd |
Pain (100) PIH (30–40) Tissue slough (3–4 pts) |
V |
| Apikan and Goodman [26] | Keloids | 50:5.7 | 100 | 14 | Biweekly | 18 | 90% resolution | 0 |
Stinging (100) PIH (100) |
IV | |
| Keloids | 50:5.7 | 100 | Every 2 weeks | 12 | Complete flattening | 0 | Ulcer (100) | IV | |||
| Manuskiatti and Fitzpatrick [25] | HTSs, keloids | 1:45 | NR | 10 | Biweekly | 8 |
30% good 70% fair improvement |
0 |
Pain (100) PIH (20–30) Tissue slough (10) |
II | |
| Davison et al. [27] | Keloids | 10:37.5a | NR | 4 | Biweekly | 6–84 | 81% excellent flattening | NR |
Pain (34) Pruritus (36) Telangiectasia (NR) |
IV | |
| Khan et al. [28] | HTSs, keloids | 4:45 | 8:90 | 8 | Weekly | 6 | 68% good-excellent, 32% no-poor improvement | 0 | NR | II | |
| Mutalik and Patwardhan [29] | HTSs, keloids | 50/40 | 150 | NR | NR | 12 | 53.3% complete flattening | 0 |
PIH (13.3) Infection (3.3) Hypopigmentation (6.7) |
IV |
NR not reported, NA not applicable
aLesions excised prior to administration of intralesional 5-FU
bKeloid group-patient self-assessment via symptom questionnaire responses
cHTSs group-patient self-assessment via symptom questionnaire responses
dFitzpatrick noted that keloids often reoccurred in his experience