Brama Rachmantyo, NIM011218046305 (2017) PERBANDINGAN HISTOPATOLOGI ANTARA TERAPI KOMBINASI LASER KARBONDIOKSIDA (CO2) DAN INJEKSI TRIAMSINOLON ASETONID DENGAN TERAPI TUNGGAL INJEKSI TRIAMSINOLON ASETONID PADA PASIEN KELOID DI RSUD Dr. SOETOMO SURABAYARJ KESEHATAN KULIT DAN KELAMIN). Thesis thesis, UNIVERSITAS AIRLANGGA.

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Abstract

Background: Keloid is a benign dermal fibrous hyperplasia. The histopathological features shows excessive fibroblasts and collagen fibers. Prevalence of keloid patient in dermatovenereology outpatient clinic of Dr. Soetomo Hospital Surabaya is 1.4% (in 2013), 1.6% (in 2014), and 1.5% (in 2015). The recurrence rate of keloid after triamcinolone injection reached 33% within 1 year. Continuous CO2 laser followed by triamcinolone injection has better effectivity (recurrence rate=15.4%). The fractional CO2 laser has a faster downtime than continuous mode, since the ablation is limited only at microscopic treatment zone. Fractional CO2 laser-triamcinolone injection combination therapy combines the selective photothermolysis effects and the antimitotic effects. Purpose: To know the effectivity of Fractional CO2 laser-triamcinolone injection combination therapy in keloid patient. Methods: This study is a clinical trial that comparing fractional CO2 laserintralesional triamcinolone combination therapy (treatment group) with intralesional triamcinolone acetonide monotherapy (control group) in keloid patients. Main parameters of this study are keloid height, fibroblast density, and collagen density. Results: This study involved 26 keloid patients (13 control patients and 13 treatment patients). Significant decrease in keloid height and collagen density occurred in the control group (p=0.005, p=0,008) and treatment group (p=0.000, p=0,001), but the difference in the decrease in keloid height and collagen density between both groups was not significant (p=0,598, p=0,328, respectively). The decrease in fibroblasts density in the control group occurred significantly (p=0.016), but in the treatment group increased insignificantly (p=0.958). The increased fibroblasts density can be due to shrinkage of collagen, so fibroblasts give a denser appearence. Conclusions: fractional CO2 laser-triamcinolone injection combination therapy has not had a better effect than a triamcinolone injection monotherapy.

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