• Mamiko Tosa, Masahiro Murakami, and Hiko Hyakusoku.
• Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School, Tokyo, Japan. tosa-m@nms.ac.jp
• J Nippon Med Sch. 2009 Feb 1; 76 (1): 9-12.

BackgroundBecause intralesional injection of triamcinolone acetonide (TA), a widely used for the treatment of keloid, is painful, many patients discontinue treatment. We evaluated the effects of pretreatment with topical 60% lidocaine tape on the pain and tolerability of intralesional TA treatment in patients with keloid.MethodsThe subjects were 42 patients with keloid who had been treated with intralesional injection of TA but had discontinued treatment owing to intolerable pain. All patients were pretreated with 60% lidocaine tape placed on the keloids for more than 120 minutes before intralesional injection of TA. Patients assessed pain with a 100-mm visual analog scale (VAS) with 0 mm for "no pain" and 100 mm for "worst possible pain." Pain was assessed with the VAS immediately after TA injection. Finally, the patients assessed the tolerability of this treatment.ResultsThe mean VAS score during intralesional TA injection therapy without pretreatment with lidocaine tape was 82.6 +/- 14.4 mm. In contrast, the mean VAS score during intralesional TA injection therapy in the same patients after pretreatment with lidocaine tape was 18.9 +/- 11.3 mm, which was significantly lower (P<.0.05), and 30 (71.4%) of the patients tolerated this therapy well.ConclusionPretreatment with 60% lidocaine tape significantly reduces the pain associated with intralesional injection of TA. This approach increases patient comfort and should enable patients to continue the treatment.

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