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Introduction: Keloids are benign skin overgrowths, often accompanied by pain and pruritis. Despite many modalities, treatment of keloids is difficult due to variable response and high recurrence rates. This study evaluated the efficacy of surgical excision compared to intralesional triamcinolone in the treatment of keloids.

Methods: This was a retrospective study. Through a medical chart review, patients with keloids treated in the Jefferson Health System from 2018-2020 were identified and included. Participants were surveyed via telephone to assess change in size, pain and pruritis of their keloid in response to treatment. Participants ranked pain and pruritis severity from 1-10 before and after treatment. Change in size, pain and pruritis symptoms were compared in those treated with excision versus triamcinolone. Significance was analyzed using a 2-tailed t-test.

Results: 503 patients were eligible, and 106 were successfully surveyed. In 50% of excised keloids (n=16), the keloid was completely gone or decreased in size by greater than 50% in response to treatment compared to 37% of for triamcinolone (n=90). The average change in itch score was -4.12 for excision, compared to -2.93 for triamcinolone (p=0.156). The average change in pain score was -3.38 for excision, compared to -1.06 for triamcinolone (p=0.009).

Discussion: Results indicate that surgical excision is more effective than triamcinolone in reducing size and pain of keloids, although there are limits to any conclusions given the low sample size for excision. The combination of reducing both pain and size could have significant impacts on bettering quality of life of keloid patients.