The main aim of this thesis was to investigate and then use this knowledge to suggest where improvements can be made in current keloid treatment. We started by exploring the current clinical practice of keloid treatment among dermatologists and plastic surgeons in The Netherlands. The most commonly used modality is triamcinolone acetonide (TAC). However, clinical results of this treatment are still highly variable and often suboptimal. This may be partly clarified by the different ways TAC is administered. Therefore, we investigated various aspects of intralesional corticosteroid administration in keloids in both scientific and clinical practice. This was followed by an e-Delphi study, that provided a uniform treatment regimen of intralesional corticosteroid administration in keloids for clinical practice. Furthermore, variation in TAC biodistribution may also be an important reason for the variable effects of TAC treatment in keloids. Therefore, the drug distribution of intralesional TAC in keloid tissue and normal skin using different drug delivery techniques was explored. Finally, in search of novel keloid treatments, we assessed a potential treatment modality based on the hypothesis that chronic inflammation mediated by the JAK-STAT pathway has an essential role in keloid pathogenesis.
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