BACKGROUND: Keloids are overgrowths of fibrous tissue following cutaneous injuries. They are often symptomatic and troubling cosmetically, with significant psychosocial burden for the patient. A safe, cost-effective alternative treatment for keloids will definitely be beneficial.
OBJECTIVES: This study aims to determine the efficacy of intralesional 5-fluorouracil versus triamcinolone acetonide in the treatment of keloids as to reduction of keloid volume, improvement of symptoms and cosmetic appearance. Adverse effects and recurrences between the two treatment groups will likewise be evaluated.
METHODS: This is a single-blind, randomized, controlled trial. Fourteen patients with 2 or more keloids on the same site or symmetrically distributed, with no co-existing morbidity and with informed consent, were included in the study. Patients received both intralesional injections of 5-fluorouracil (5-FU, Utoral 50 mg/mL) and triamcinolone acetonide (TAG, Kanolone 10 mg/mL). One keloid was injected with 5-FU and one with TAG. They were submitted to 1-6 treatment sessions with an average interval of 2 weeks between each session. Measurements of keloid volume using alginate impression material and digital photographs were taken before treatment, 2 weeks and 2 months post-treatment. Occurrence of adverse effects, improvement of symptoms, as well as cosmetic outcome, was likewise recorded.
RESULTS: Both 5-fluorouracil and triamcinolone acetonide were shown to be effective in the treatment of keloid. Comparing the two, 5-FU statistically proved to be better, by having greater volume reduction, more symptom improvement, and higher scores on patient's assessment of cosmetic outcome. Adverse sequelae were pain, hyperpigmentation, and ulceration which healed in 1 - 2 weeks with topical antibiotic ointment. Corticosteroid side effects such as telangiectasia and atrophy were not appreciated with the 5-FU group. There was no recurrence during the follow-up period of 8 weeks in any of the patients.
CONCLUSION: Five-fluorouracil was shown to be effective in reducing keloid volume, improving symptoms of pain and pruritus, and cosmetic outcome, as compared to triamcinolone acetonide. Likewise, it was found to be safe. Adverse effects associated with corticosteroids were not seen. No recurrence was noted two months post-treatment.

Human ; Male ; Female ; Adult ; Young Adult ; Adolescent ; Anti-bacterial Agents ; Glucuronic Acid ; Hexuronic Acids ; Hyperpigmentation ; Injections, Intralesional ; Keloid ; Pruritus ; Telangiectasis ; Triamcinolone Acetonide

Background: The COVID-19 pandemic continues to afflict nations worldwide. The Philippines is no exception which has recorded more than 3 million cases as of December 2021 with children comprising 12% of total cases. Since the start of the pandemic, the Pediatric Infectious Disease Society of the Philippines (PIDSP) has been collecting data nationwide, through an online pediatric COVID-19 registry (SALVACION registry), to provide a better understanding of COVID-19 in children in the local setting. Methods: This was an ambispective cohort study of pediatric COVID-19 cases in the Philippines reported from March 2020 to December 2021. Data on clinical features, laboratory findings, disease severity, and treatment outcomes were voluntarily reported by physicians across the country. This study was approved by the Department of Health Single Joint Research Ethics Board. Results: As of December 30, 2021, there were 2,127 cases reported in the registry, with a median age of 5 years (interquartile range: 1-13 years) and mostly mild (41.9%) or moderate (24.5%) in severity. The top symptoms reported were fever (57.9%), cough (42.7%), coryza/colds (29.4%), anorexia (25.2%), and difficulty of breathing (23.1%). The most common comorbidities were hematologic-oncologic diseases (7.4%), neurologic diseases (7.0%) and surgical conditions (4.4%), while the most common coinfections were sepsis (6.3%), dengue fever (4.8%) and healthcare-associated pneumonia (2.1%). Significantly higher median CRP, procalcitonin, D-dimer, ferritin, transaminases and lactate dehydrogenase were seen among severe/critical cases compared to non-severe cases. There was a high frequency of antibiotic use (58%). Most cases recovered, although 172 deaths were reported with an 8.6% case fatality rate. The most common comorbidities in those who died were neurologic (15.7%), cardiac (12.8%) and hematologic (11.6%) diseases. Conclusion Children across all age groups are susceptible to COVID-19 and most cases are mild or moderate in severity. Among severe and critical cases, the most common comorbidities were neurologic, hematologic-oncologic and cardiac diseases. Most patients recovered with supportive management.
COVID-19 ; SARS-CoV-2 ; Child ; Registries ; Philippines