Abstract: Objective: To compare the efficacy and adverse reactions between intralesional betamethasone injection combined with botulinum toxin type A and topical hyaluronic acid and simple intralesional betamethasone injection and topical hyaluronic acid in treatment of keloid. Methods: A total of 58 patients with keloid were divided into two groups:intralesional betamethasone injection combined with botulinum toxin type A and topical hyaluronic acid group (combined group, n=28) and intralesional betamethasone injection combined with topical hyaluronic acid group (control group, n=30). In both two groups, the intralesional betamethasone injection was given once every 4 weeks for 3 times totally, and topical hyaluronic acid was applied every day. In combined group, an injection of botulinum toxin type A was given around the lesion after the first intralesional injection of betamethasone. The parameters for therapeutic efficacy and adverse reactions of the patients in two groups were recorded, and the clinical pictures were taken before and after each treatment, and they were analyzed and compared. Results: After 3 treatments, compared with control group, the lesion appearance in combined group was improved. In control group, the VAS value was reduced at 1 month, but was increased gradually at 2 and 3 months. In combined group, the VAS value was reduced gradually in 3 months. There was a significant difference in VAS value at 2 and 3 months between two groups (P<0.05). In combined group, the thickness of keloids were reduced gradually in 3 months, while the reduction was not obvious in control group (P<0.05). The recurrence of pain, itching and lesion height were observed 2 weeks after each treatment in control group, but there was no recurrence in combined group. The incidence rate of adverse reactions was 26.7% in control group, which had no significant difference compared with combined group(25.0%) (P>0.05). Conclusion: Compared with control group, the combined group shows better efficiency in the treatment of keloid and there is no increase of adverse reactions. The therapy is worthy of clinical application.

Key words: keloid, botulinum toxin type A, betamethasone, pain measurement