Initial treatment of keloid -

Ans. is 'b' i.e., Intralesional steroid Imralesional injection of steroid (Triamcinolone acetate) is now recommended as the first line of t/t for keloids" Schwartz"Intralesional injection of Triamcinolone is also the t/t o f choice for intractable hypertrophic scars. Success is enhanced when it is combined with surgical excision" CSDT13/epi 105o Other modalities of t/t used for keloids are:SurgerySurgical excision alone leads to a high recurrance rate.There are fewer recurrances wrhen surgical excision is combined with other modalities such as intralesional corticosteroid injection, topical application of silicone sheets or the use of radiation or pressure.Surgery is recommended for debulking large lesions.Radiation therapyIt may produce unpredictable results and has obvious potential side effects including neoplastic degeneration; and has high recurrance rate wrhen used alone.Silicone sheet applicationPressure applicationTopical retinoids