KELOID

Course overview

KELOIDS RESULT FROM ABNORMAL WOUND HEALING IN RESPONSE TO SKIN TRAUMA OR INFLAMMATION. KELOID DEVELOPMENT RESTS ON GENETIC AND ENVIRONMENTAL FACTORS. HIGHER INCIDENCES ARE SEEN IN DARKER SKINNED INDIVIDUALS OF AFRICAN, ASIAN, AND HISPANIC DESCENT. OVERACTIVE FIBROBLASTS PRODUCING HIGH AMOUNTS OF COLLAGEN AND GROWTH FACTORS ARE IMPLICATED IN THE PATHOGENESIS OF KELOIDS. AS A RESULT, CLASSIC HISTOLOGIC FINDINGS DEMONSTRATE LARGE, ABNORMAL, HYALINIZED BUNDLES OF COLLAGEN REFERRED TO AS KELOIDAL COLLAGEN AND NUMEROUS FIBROBLASTS. KELOIDS PRESENT CLINICALLY AS FIRM, RUBBERY NODULES IN AN AREA OF PRIOR INJURY TO THE SKIN. IN CONTRAST TO NORMAL OR HYPERTROPHIC SCARS, KELOIDAL TISSUE EXTENDS BEYOND THE INITIAL SITE OF TRAUMA. PATIENTS MAY COMPLAIN OF PAIN, ITCHING, OR BURNING. MULTIPLE TREATMENT MODALITIES EXIST ALTHOUGH NONE ARE UNIFORMLY SUCCESSFUL. THE MOST COMMON TREATMENTS INCLUDE INTRALESIONAL OR TOPICAL STEROIDS, CRYOTHERAPY, SURGICAL EXCISION, RADIOTHERAPY, AND LASER THERAPY. THIS ACTIVITY REVIEWS THE EVALUATION AND TREATMENT OF KELOIDS AND THE ROLE OF THE INTERPROFESSIONAL TEAM IN MANAGING AND EDUCATING PATIENTS WITH THIS CONDITION.