Sir,
The recent letter by Azad and Sacks conveyed a simple modification of the steroid-injection technique for hypertrophic scars and keloids.
1.
We do appreciate this method of achieving a virtually painless injection. However, we are concerned about the needle prick adjacent to the actual scar because this can give rise to another keloid. The principle of keloid excision is that subsequent injection should always be intralesional in order to avoid a potential hypertrophic or keloid scar in the vicinity. The speed of injection is an important determinant of pain in intralesional chemotherapy.2.
Therefore, we think that slow injection of a lidocaine-mixed preparation of steroid using an electric pump is the best solution.Yours faithfully,
References
- Painless steroid injection for hypertrophic scars and keloids.Br J Plast Surg. 2002; 55: 534
- Pain-free intralesional injection of triamcinolone for the treatment of keloid.Scand J Plast Reconstr Surg Hand Surg. 1999; 33: 89-91
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© 2003 Published by Elsevier Inc.
