Vancouver Scar Scale

Intralesional triamcinolone acetonide (TAC; a synthetic corticosteroid) and 5-fluorouracil (5-FU; a cytotoxic chemotherapy drug) are the medications most commonly used to treat keloid scars. Kaur et al. investigated the clinical efficacy of TAC compared with 5-FU. They included 40 patients in the study and divided them into two equal groups (n = 20 Group A; n = 20 Group B). Group A patients received 4 mg/cm2 or 0.1 ml/cm2 of intralesional TAC (40 mg/ml) at 3-week intervals. Group B patients received 10 mg/cm2 or 0.2 ml/cm2 of intralesional 5-FU (50 mg/ml) at 3-week intervals. They assessed the scar using the Vancouver Scar Scale (VSS), visual analog scale (VAS), and patient satisfaction score (PSS). They found that Group A patients had a lower VAS than Group B patients (2.09 vs. 3.18). They saw a reduction in the VSS in both treatment arms; however, they found that Group B patients had a more marked reduction in the VSS compared with Group A patients (2.57 vs. 2.68). The PSS was higher in Group A than in Group B (1.97 vs. 1.78). They concluded that intralesional 5-FU elicits a better response than intralesional TAC. Although 5-FU is less well tolerated and has more side effects than TAC, we found that 5-FU was more effective in resolving keloid scars. Notably, the PSS was higher in the TAC group, but the VSS and VAS were better in Group B ¹⁾.