Eficacia de acetónido de triamcinolona intralesional versus 5-fluorouracilo intralesional para el tratamiento de cicatrices hipertróficas y queloides: revisión sistemática

Abstract

Background: Hypertrophic scars and keloids are fibroproliferative disorders resulting from an abnormal skin healing response, causing aesthetic, functional, and psychological impairment. Among the therapeutic options, intralesional injections of triamcinolone acetonide (TAC) and 5-fluorouracil (5-FU) have shown efficacy. However, controversy persists regarding which provides better outcomes in terms of volume reduction, symptomatic improvement, and adverse effects. Objective: To determine the efficacy of intralesional triamcinolone acetonide compared to intralesional 5-fluorouracil in the treatment of hypertrophic scars and keloids. Methods: A systematic review was conducted following the PRISMA 2020 guidelines, including randomized controlled trials (RCTs) studies that guarantee robustness of the results. The risk of bias was assessed using the ROB-2 tool. Results: The reviewed studies indicate that intralesional 5-fluorouracil is more effective in reducing the volume of keloid and hypertrophic scars compared to triamcinolone acetonide. Moreover, 5-FU has a more favorable safety profile, with fewer adverse effects such as skin atrophy and hypopigmentation. However, TAC remains superior in managing inflammatory symptoms such as pruritus and pain, suggesting that treatment choice should be based on the individual characteristics of each lesion and the patient’s therapeutic priorities. Discussion: Intralesional 5-FU appears to be preferable for reducing scar size, whereas TAC is useful in cases with prominent inflammation. Therefore, combining both agents may optimize clinical outcomes. Treatment decisions should be individualized based on symptoms and tolerance. Keywords: triamcinolone acetonide, hypertrophic scar, 5-fluorouracil, keloids