Introduction/Aim. Keloid is a benign proliferative lesion of the dermal connective tissue. It is a challenging clinical problem, despite multiple therapies reported until now. The aim of the study was to determine the efficacy of intralesional methotrexate in the treatment of keloid in comparison to intralesional triamcinolone. Methods. This is an interventional comparative therapeutic study carried out at the Department of Dermatology in Al-Kindy Teaching Hospital, from April 2019 to January 2021. A total of 28 patients with 56 lesions were enrolled in this study; their ages ranged from 16 to 60 years, and they were satisfied with the selection criteria. Lesions were classified into two groups: Group A - 28 lesions treated with intralesional methotrexate and Group B - 28 lesions treated with intralesional triamcinolone. The treatment sessions were scheduled every four weeks. The Vancouver Scar Scale was used for the evaluation. A calculation of the mean decrease in total score was performed, and photographs were taken. Results. In both study groups, a significant reduction in height and pliability was seen in lesions treated with triamcinolone compared to lesions treated with methotrexate but no significant difference between the two drugs in vascularity and pigmentation were seen at the end of the study. Means of Vancouver Scar Scale in both groups after six months of treatment decreased significantly, and better results were seen with triamcinolone in comparison to methotrexate. Conclusion. The two modes of therapy were effective, however, better results were seen with triamcinolone in the treatment of keloid.
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