Fractional Laser As Laser Assisted Drug Delivery of Triamcinolone Acetonide in Keloid

Abstract

Background: Keloid is benign hyperplasia of dermal collagen which may or may not be preceded by injury in susceptible person. Keloids are refractory to treatment most of the times. Intralesional corticosteroid, topical retinoic acid, topical imiquimod cream, surgery, cryotherapy, laser, and silicon sheeting are mainly used for treatment. Fractional ablative laser is a new laser treatment modality that create numerous microscopic thermal injury zone controlled width, depth, and density that are surrounded by a reservoir of spared epidermal and dermal tissue, allowing of rapid repair of laser-induced thermal injury. Multiple studies demonstrate that laser pretreatment of the skin can increase the permeability and depth of penetration of topical drug molecules. Main observations: A boy, 12 years, scar that arise after burn scar 14 months ago. Scar was felt bigger and thickening also itching. Patient was diagnosed keloid and had been treated with same-session ablative fractional laser and topical triamcinolone acetonide after therapy. Patient had been treated 5 sessions with 3 weeks of interval. Successful of treatment was measured with reduction of keloid size and vancouver scar scale (VSS). Conclusions: Laser assisted drug delivery is an envolving technology with potentially broad clinical application. Ablative fractional laser treatment create vertical channels that might assist the delivery of drug into skin. Combination same-session therapy with ablative fractional laser and triamcinolone acetonide offer a good combination caused assisted delivery of drug.