A型肉毒毒素联合曲安奈德注射及脉冲染料激光可显著改善病理性瘢痕OA

Objective To evaluate the clinical efficacy and safety of combined treatment with botulinum toxin type A(BTX-A)injections,triamcinolone acetonide(TAC)injections,and pulsed dye laser(PDL)therapy for pathological scars.Methods A retrospective analysis was conducted on patients with hypertrophic scars or keloids diagnosed at Guangzhou Dermatology Hos-pital from January 2022 to September 2023.The treatment protocol for one cycle(3 months)com-prised a single perilesional injection of BTX-A in the first month,followed by intralesional injec-tion of TAC solution combined with PDL therapy in both the second and third months.Patients re-ceived 2 to 4 such cycles.Evaluations were performed before treatment,at 6 months(mid-treat-ment),and at the 6-month follow-up after treatment completion.Assessment tools included the vancouver scar scale(VSS)and a physician's global assessment,and adverse events were recor-ded.Results Twelve patients(4 males,8 females),aged 23-65 years(mean:38.4 years),with 15 scars were included.The VSS scores were 10.60±2.64 at pre-treatment,6.33±2.90 at mid-treatment,and 4.53±2.39 at the 6-month follow-up.The differences in VSS scores across these time points were statistically significant(F=101.71,P＜0.001).The VSS score at mid-treatment was significantly lower than the pre-treatment score,with a further significant reduction at the 6-month follow-up compared to the pre-treatment(both P＜0.001).Clinical assessment in-dicated significant improvement in 10 scars and improvement in 5 scars,resulting in a significant improvement rate of 66.67％ and an overall effective rate of 100％.Mild adverse events were ob-served in four cases,including telangiectasia(2 cases),folliculitis(1 case),and local epidermal necrosis(1 case).Conclusion The combination therapy of BTX-A,TAC injections,and PDL significantly improves pathological scars with minimal adverse effects.