This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
[{'content': 'First line t/t for keloid is- \nSelect and explain. \nA. Intralesional injection of steroid, B. Local steroid, C. Radiotherapy, D. Wide excision', 'role': 'user'}, {'content': 'Answer: A \nExplanation: Intralesional injection of steroid (Triamcinolone acetate) is now recommended as the first line of t/t for keloids \nIntralesional injection of Triamcinolone is also the t/t of choice for intractable hypertrophic scars. Success is enhanced when it is combined with surgical excision \nOther modalities of t/t used for keloids are:\n\na) Surgery\n\nsurgical excision alone leads to a high recurrance rate.\nthere are fewer recurrances when surgical excision is combined with other modalities such as intralesional corticosteroid injection, topical application of silicone sheets or the use of radiation or pressure.\nsurgery is recommended for debulking large lesions.\n\nb) Radiation therapy\n\nit may produce unpredictable results and has obvious potential side effects including neoplastic degeneration; and has high recurrance rate when used alone.\n\n\nSilicone sheet application\nPressure application\nTopical retinoids', 'role': 'assistant'}]