Publication:

A study of verapamil in treatment of keloid

Background Keloid is a common presentation in clinical practice. Symptoms due to keloid are mild, but disfigurement and functional impairment can be severe. It is difficult to treat. Intralesional, injection triamcinolone acetonide, has limited efficacy, causes adverse effects such as local dermal atrophy, telengiectasia and hypopigmentation. Injection verapamil is reported to have similar efficacy, but lesser side effects, and is cheaper. Aim was to study efficacy and adverse effects of intralesional verapamil in treatment of keloid.

Methods An open label study on 25 patients of keloid, either gender, age 11 to 55 years at a medical college hospital. Injection verapamil 2.5 mg/ml was administered intralesionally, at an interval of 3 weeks, for a total of 6 sittings, over a period of 18 weeks. Vancouver scar scale (VSS) was used to assess the improvement. The statistical analysis was done using SPSS version 21.0.

Results Median duration of keloids was 8 months. The mean VSS score before treatment was 7.68 which reduced to 4.28 after treatment. Mean percentage change in VSS score was 46.21%, very highly significant (p<0.001). Physician’s assessment was ‘very good’ in 32.0% and 'excellent' in 8.0%. The complaint of post-procedure pain was present in almost all.

Conclusions Intralesional injection verapamil, gives very good to excellent improvement in 40% of patients of keloid. Post injection pain persists for more than 24 hours. Drug does not cause local dermal atrophy or hypopigmentation.