Clinical Implications of Single- Versus Multiple-Site Keloid Disorder

Abstract

Keloid disorder is one of the most frustrating problems in wound healing and advances in our understanding of the differences of occurrence at a single site versus multiple sites might help in understanding pathogenesis and improving treatment.

Comprehensive Review of Keloid Formation

“…As we said before, some patients have hereditary of spontaneous keloids, while others have association with blood group A [27]. There is confirmed evidence of the association between spontaneous keloid formation and different diseases such as Dubowitz syndrome, Rubenstein-Taybi syndrome, and Noonan syndrome [36]. In addition, Spontaneous keloid has been reported in siblings and in people with allergic disease [49].…”

“…Also, there is predisposition to heredity spontaneous keloids, which usually appears in the second decade, and for heredity presternal and shoulder keloids [27]. In addition, family history is strongly associated with the formation of keloid scars in multiple sites as opposed to a single anatomical site [4,28,36,37].…”

Massive ear keloids: Natural history, evaluation of risk factors and recommendation for preventive measures – A retrospective case series

“…Although no convincing genetic abnormalities have been linked to KD, clinical observation suggests that the genetic predisposition to KD has a broad spectrum 2 . Individuals who suffer from mild form of the disorder typically develop one or few slow-growing keloidal lesions, whereas individuals with the severe form of the disorder often develop several large keloids.…”

“…Most importantly, there must exist an injury to the skin that would trigger abnormal wound healing response that leads to the formation of keloid lesions 2 . Figure 1 depicts a young African American male who developed an earlobe keloid following the piercing of his right ear.…”

“…The clinical presentation of KD is to some extent race and gender dependent. Large and tumoral keloids, including massive ear lesions, are more often encountered among Africans, African Americans and individuals with black skin 2 .…”