فهرست نشریات علمی دسترسی آزاد ایران

The management of keloids remains Challenging. Repeated intralesional corticosteroid injections are the first-line therapy; however injection alone is often suboptimal, especially for large keloid lesions. Narrowband ultraviolet B (NB-UVB) phototherapy is a viable treatment option for extensive keloids. We report an excellent response in a large keloid lesion (approximately 100 cm2) treated with NB-UVB phototherapy combined with intralesional triamcinolone acetonide (TA) injections. A 21-year-old woman presented with a clinical diagnosis of keloid that had previously been treated with a combination of intralesional TA injections and 5-fluorouracil without significant improvement. Targeted NB-UVB phototherapy was administered twice weekly for a total of 86 sessions, with a cumulative dose of 83.3 J/cm2. Additionally, the thick lesions received intralesional TA injections at a concentration of 10 mg/mL, 1 mL weekly for 4 months, then biweekly for 3 months. Triamcinolone acetonide was injected into different parts of the lesion each time to avoid exceeding the maximum dose per injection site. The keloid showed marked improvement, with the Vancouver Scar Scale score decreasing from 11 to 1. Synergistically, NB-UVB phototherapy and corticosteroid injections reduced collagen synthesis and fibroblast proliferation, while also including degeneration of collagen and fibroblasts. The combination of NB-UVB phototherapy and intralesional TA injections produced an excellent therapeutic response in this large keloid lesion.