A 20-year-old man with a keloid over the earlobe following piercing seeks treatment. Which is the established first-line medical therapy?

• A Oral prednisolone taper
• B Oral tranexamic acid
• C Topical tretinoin application
• D Intralesional triamcinolone acetonide injection ✓

Explanation

Monthly intralesional triamcinolone acetonide, typically 10 to 40 mg/mL, flattens most keloids and relieves pruritus, and it is the accepted first-line agent either alone or combined with excision. Steroids reduce collagen synthesis and increase collagenase activity. Excision alone carries a very high recurrence rate, often worse than the original lesion, so it is not offered as monotherapy.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.