Keloids & Hyperytrophic Scars Flashcards
What is a keloid
Benign firm dermal fibroproliferative tumor with no malignant potential that result from overgrowth of dense fibrous tissue after healing of skin injury , expand beyond injury boundaries and do not resolve spontaneously
What are hypertrophic scars
Erythematous Pruritic raised fibrous lesions that do not expand beyond boundaries of skin injury and may resolve spontaneously
Primary causation of keloids
Trauma to the skin
acne
chicken pox
Race more susceptible to having keloids
People with dark complexion or Black people
Pathophysiology of keloids formation
Imbalance between catabolic and anabolic stages in healing process with more collagen produced than degraded and hyperemic scar
Is collagen synthesis greater in keloids or greater in hypertrophic scar
Three times greater in keloids
Histology of hypertrophic scars and keloids
Collagen nodule with high density fibroblast and unidirectional type III collagen fibrils arranged in swirls
Rich vasculature
high mesenchymal cells density
thickened epidermal cell layer
Main histological difference between hypertrophic scars and keloids
Broad, dull, pink bundles of collagen in keloids not present in hypertrophic scars
Who is more at risk of keloids , men or women?
Women
Age with highest incidence of keloids
10-30 years
Main body areas affected by keloids
Earlobes
face
neck
lower extremities
breasts
chests
back
abdomen
Complications of keloids
Ulceration from trauma
infection
malignant change especially fibrosarcoma
itching
tenderness
Possible therapeutic measures in keloids
Occlusive dressing
compression therapy
intralesional corticosteroid injections
cryosurgery
excision
radiation therapy
laser therapy
Recurrence rate of excision done alone in keloids treatment
50-100%
Is excision followed by triamcinolone steroid injection usually successful
Yes
