Keloid

In this post we shall discuss about Keloid formation and treatment

Keloid is a defect in maturation and stabilization of collagen fibrils as normal collagen bundles are absent

It is common in females

Mostly seen in black people

Genetically predisposed and very rare in Caucasians

Keloid grows even after 6 months. It extends into adjacent normal skin. It is brownish black/pinkish black in color, painful, itchy and hyperaesthetic.

Keloids can be associated ot Ehlers Danlos Syndrome or Scleroderma

Spontaneous keloid is formed when an unnoticed trauma heals without scar formation.

Some keloids don’t grow after an initial growth

Keloid contains proliferating immature blood vessels and type III thick collagen stroma and immature fibroblasts.

Keloids are common over sternum along with upper arm, chest wall, front of lower neck


Precipitating Factors

Black People

Tuberculosis patient

Vaccination site


Complications

Infection

Ulceration


Treatment

Excision and skin grafting can be done

Vit. E/ palm oil massage

Intrakeloidal triamcinolone injection once in 7-10 days followed by excision. The usual sequence is Steroid injection – Excision – Steroid Injection

Methotrexate and Vit. A

Compression dressings with silicone gel sheets

Laser therapy

Intra lesional excision retaining the scar margin could prevent recurrence. It is preferred over only excision.