3. Biodistribution of needle-injections and needle-free jet-injections visualized by a 3D- Fluorescent Imaging Cryomicrotome System 74 ABSTRACT Introduction Intralesional corticosteroid injections are a first-line treatment for keloids; yet clinical treatment results are highly variable and often suboptimal. Variation in triamcinolone acetonide (TCA) biodistribution may be an important reason for the variable effects of TCA treatment in keloids. In this exploratory study we investigated the biodistribution of TCA in keloids and normal skin using different drug delivery techniques. Methods Fluorescent-labeled TCA suspension was administered into keloids and normal skin with a hypodermic needle and an electronic pneumatic jet injector. TCA biodistribution was represented by the fluorescent TCA volume and 3D biodistribution shape of TCA, using a 3D-Fluorescence-Imaging Cryomicrotome System. Results Twenty-one keloid and nine normal skin samples were analyzed. With needle injections, the mean fluorescent TCA volumes were 990 µl ± 479 in keloids and 872 µl ± 227 in normal skin. With the jet injector, the mean fluorescent TCA volumes were 401 µl ± 252 in keloids and 249 µl ± 67 in normal skin. 3D biodistribution shapes of TCA were highly variable in keloids and normal skin. Conclusion TCA biodistribution in keloids is highly variable for both needle and jet injection. This may partly explain the variable treatment effects of intralesional TCA in keloids. Future research is needed to confirm this preliminary finding and to optimize drug delivery in keloids.
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