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Introduction: Keloids are benign exophytic scars ranging from asymptomatic, small papules to large symptomatic plaques that affect patients’ quality of life. The most effective treatment for this troublesome condition has yet to be determined. This study aims to demonstrate that intralesional Kenalog injections produce better keloid outcomes than surgical excision.

Methods: Researchers called 504 Jefferson keloid patients to determine their keloid outcomes post-treatment. Patients were asked to confirm their last treatment method, describe the percent change in size of their lesion(s), and rate their symptoms (pruritis and pain) on a scale of 0-10 before and after treatment. Excision and Kenalog group outcomes were compared using t-tests.

Results: 84 patients with 114 keloids responded to the survey. Of these keloids, 16 were excised and 90 were treated with Kenalog. While excised keloids and Kenalog-injected keloids comparably produced some decrease in size (81% vs. 77%), more excised keloids resolved completely (37% vs. 10%) and more Kenalog-treated keloids decreased less than 50% in size (41% vs. 19%). However, the excision group also showed more cases of increased keloid size (13% vs. 4%). Comparison of symptom scores showed no significant difference in pruritus scores (p = 0.156), but demonstrated that excisions reduced pain scores significantly (p = 0.009).

Discussion: The results of this study suggest that excised keloids produce better size and pain reduction than Kenalog-injected keloids. However, outcome analysis was limited by the survey responses collected, as consenting patients mainly received Kenalog treatments. Thus, further research is necessary to accurately determine which treatment modality is most effective.