Clinical outcome and quality of life of patients with earlobe keloids after a multimodal therapy approach

Objective To investigate the clinical effects of early postoperative magnet application and triamcinolone acetonide injection in patients with earlobe keloids after surgery,and the role in improving the quality of life. Methods A total of 56 patients with 64 earlobe keloids were enrolled in a prospective cohort study.All the patients underwent intramarginal keloid excision followed by triamcinolone acetonide injection (20-40 mg,one time 1 every 2 weeks,total 5 times) and post-excisional pressure therapy with magnetic disks (8 hours every day for total 6 months).The follow up was 12 to 36 months.The quality of life of patients evaluated. Results Four patients (with 5 keloids) were lost in the follow-up.6 of 59 keloids recurred with a rate of 10.2% and 1 mean time of 9±9 months.The itching and pain after the treatment were improved significantly.The score for the itching and pain both before and after the treatment were not statistically significant.The quality of life after the treatment was improved,the mean GBI score was 29.98±16.97,18.13±11.13 in the recurrence group and 32.14±17.04 in the non-recurrence group (P<0.05).The size of the keloids with a relapse was (5.53±4.88) cm³,without a relapse was (5.32±3.87) cm³,there was no statistical significant between the two groups (P>0.05).The relapse rate in patients with a positive family history was 15% and in patients without a positive family history was 15.6%,the different was not significant.The mean score for satisfaction was 3.54±0.73 and the satisfaction rate was 90.4%,the score for satisfaction in the recurrence group was 2.88±1.13,which was lower than 3.66±0.57 in the non-recurrence group (P<0.05);The mean score for the comfortability of magnetic disk was 3.62±0.53,3.70±0.46 in the non-recurrence group which was higher than 3.13±0.83 in the recurrence group (P<0.05). Conclusion The early postoperative magnet application and triamcinolone acetonide injection in patients with earlobe keloids is effective and safe,which can reduce the relapse rate of earlobe keloid and improve the quality-of-life of patients.