Multimodal Management of Facial Keloid with Tissue Expansion, Excision, and Injection of 5-FU and Triamcinolone

Keloids are benign, fibroproliferative dermal growths that occur in response to injury of the skin. These hypertrophic scars can cause pain and discomfort and have been associated with negative effects on social well-being, prompting physicians to seek effective treatment modalities with minimal risk of recurrence. Although surgical excision of the keloid initially removes the scar tissue, surgery alone triggers a fibroproliferative response similar to the initial insult, resulting in a high recurrence rate. Thus, a multimodal approach may be most appropriate when surgery is indicated to limit recurrence. We present the successful treatment of recalcitrant keloid formation of the face that was treated with tissue expansion, excision, and intralesional triamcinolone and 5-flurouracil injections.