A novel approach of neoadjuvant and adjuvant therapy with surgery for large keloids of the ear

Background: Ear keloids form after ear piercing in genetically predisposed young adults, causing cosmetic disfigurement and negative psycho-social impact, reducing quality of life. Total excision leads to loss tissue distorting framework reconstruction restore esthetically pleasant causes scarring more aggressive keloids. Rate recurrence is higher than 80% when surgical alone done. Aims Objectives: The study was conducted compare the efficacy intralesional triamcinolone acetonide (TAC) or 5-fluorouracil (5 FU) as monotherapy, combined TAC+5 FU multi-modal therapy (TAC+5 FU+surgical excision) for ear. Materials Methods: prospective comparative included 30 patients who presented out-patient clinic plastic surgery department Government Mohan Kumaramangalam Medical College Hospital, Salem a duration 2 years from January 2021 December 2022. Patients were categorized into three groups based on size keloids, Group I (10) – Injection TAC (A) 5- (B), II (10): TAC+5-FU, III TAC+5- FU+Surgical (A neoadjuvant+adjuvant; B only adjuvant). Results: Of total patients, IIIA showed significant reduction keloid with least side effects, most pleasing cosmetically (Patient observer scar assessment scale 1/10). No follow up. Conclusion: Multi-modal consisting neoadjuvant excision, adjuvant offers best long-term results large