Keloid disease: Review with clinical atlas. Part I: Definitions, history, epidemiology, clinics and diagnosis

Delaleu, Jérémie; Charvet, Estelle; Petit, Antoine

doi:10.1016/j.annder.2022.08.010

Cited by 13 publications

(27 citation statements)

References 51 publications

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“…This unregulated growth distinguishes keloids from hypertrophic scars (HTSs), which are raised but do not extend beyond the boundaries of the original wound 1 . Because of their uncontrolled growth, keloids are currently considered to represent a form of benign fibroproliferative tumour rather than a scar, and the terms ‘keloid disorder’ or ‘keloid disease’ are increasingly used in cases of patients presenting with multiple keloid lesions 2–4 . Keloids are disfiguring, which may negatively affect body image, and they may restrict range of motion when they occur across joints 1 .…”

Section: Keloids: More Than Just ‘Scars’mentioning

confidence: 99%

“…Keloids are disfiguring, which may negatively affect body image, and they may restrict range of motion when they occur across joints 1 . In addition, keloids can be very itchy and painful; pruritis and/or pain are present in a majority of keloid patients and contribute significantly to impaired quality of life 3,5–8 . Treatment of keloids is notoriously challenging, despite the existence of numerous therapeutic modalities 9,10 .…”

Section: Keloids: More Than Just ‘Scars’mentioning

confidence: 99%

“…1 In addition, keloids can be very itchy and painful; pruritis and/or pain are present in a majority of keloid patients and contribute significantly to impaired quality of life. 3,[5][6][7][8] Treatment of keloids is notoriously challenging, despite the existence of numerous therapeutic modalities. 9,10 Algorithms for treatment of keloids have been proposed, 11,12 yet there is no standard treatment that is effective for all keloids, and recurrence rates for most common therapies are very high.…”

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confidence: 99%

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A role for vitamin D and the vitamin D receptor in keloid disorder

Hahn

Combs

Powell

et al. 2023

Wound Repair Regeneration

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Keloids are disfiguring fibroproliferative lesions that can occur in susceptible individuals following any skin injury. They are extremely challenging to treat, with relatively low response rates to current therapies and high rates of recurrence after treatment. Although several distinct genetic loci have been associated with keloid formation in different populations, there has been no single causative gene yet identified and the molecular mechanisms guiding keloid development are incompletely understood. Further, although it is well known that keloids are more commonly observed in populations with dark skin pigmentation, the basis for increased keloid risk in skin of colour is not yet known. Because individuals with dark skin pigmentation are at higher risk for vitamin D deficiency, the role of vitamin D in keloid pathology has gained interest in the keloid research community. A limited number of studies have found lower serum vitamin D levels in patients with keloids, and reduced expression of the vitamin D receptor (VDR) in keloid lesions compared with uninjured skin. Vitamin D has documented anti‐inflammatory, anti‐proliferative and pro‐differentiation activities, suggesting it may have a therapeutic role in suppression of keloid fibrosis. Here we review the evidence supporting a role for vitamin D and VDR in keloid pathology.

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Section: Keloids: More Than Just ‘Scars’mentioning

confidence: 99%

Section: Keloids: More Than Just ‘Scars’mentioning

confidence: 99%

mentioning

confidence: 99%

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A role for vitamin D and the vitamin D receptor in keloid disorder

Hahn

Combs

Powell

et al. 2023

Wound Repair Regeneration

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“…Unlike hypertrophic scars, keloids extend beyond the boundaries of the original wound and do not regress over time. 3 , 4 …”

Section: Introductionmentioning

confidence: 99%

“…The pathogenesis of keloids is initiated by a confluence of systemic and local variables, including hormonal imbalances, mechanical tension, metabolic perturbations, and inflammatory processes, as demonstrated by several studies. 4 , 5 These abnormal scars are mostly composed of disorganized collagen bundles, especially type one and three collagen. The mechanism of keloid formation is complex and not fully understood yet.…”

Section: Introductionmentioning

confidence: 99%

Keloid Scar Resistance to Intralesional Steroid Injections: Should We Look for Foreign Bodies? A Case Report

Alfurayh,

Alqahtani,

AlFada

2023

CCID

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Keloid is a challenging pathological condition characterized by abnormal scarring that extends beyond the boundaries of the original wound. Despite the available treatment options, keloid scars remain difficult to manage. This case report discusses a 10-year-old boy with a keloid scar on his neck following branchial anomaly repair surgery. The patient underwent multiple treatments, including triamcinolone injections, cryotherapy, and a pulsed dye laser session, with limited improvement. Subsequently, an X-ray and ultrasound were performed revealing the presence of metallic clips over the surgical site. To our knowledge, the effect of the presence of foreign bodies within the keloid scar on its response to treatment is not well understood yet. The findings of this case encourage performing imaging studies on post-surgical keloid scars resistant to treatment to rule out the presence of any foreign material. However, more trials to investigate the effect of the presence of foreign bodies on the treatment of keloid scar are required before it can be set as a mandatory investigation.

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Massive facial keloid precipitated by chronic suppuration and mechanical skin traction: A case report

Banda,

Ngalamika,

Zuze

et al. 2024

Skin Health and Disease

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Keloids are benign fibroproliferative tumours with a high recurrence rate of 20%–100%, therefore, multimodal treatment is recommended. We report the case of an exceptionally large facial keloid precipitated by a vicious cycle of chronic inflammation and mechanical skin traction and discuss the management challenges in a low resource setting. A 67‐year‐old man presented with a 10‐year history of a facial keloid that rapidly enlarged to 2,800 g in 2 years causing difficulties eating, speaking, dressing, head movements and breathing. He had multiple other smaller keloids, hypertension, HIV, and a keloid family history. Surgical excision of the keloid including the multiple sinuses and cysts of enclosed skin with growing hair found inside was performed. A posterior skin flap was used to achieve tension free closure and monthly triamcinolone injections commenced. Histology showed keloidal collagen bundles in a fibrotic background, foci of a lymphoplasmacytic infiltrate and multinucleated foreign body type giant cells consistent with chronic inflammation. CD34 and S100 immunohistochemistry were both negative, ruling out the differential diagnoses that included dermatofibroma. Recovery was uneventful and the patient was discharged after 2 weeks. Notably, radiotherapy was not available in our country. We report this unique case of an extremely large keloid to demonstrate the role of suppurative chronic inflammation and high skin tension in accelerated keloid growth. This case also highlights the severe global disparity in the availability of effective keloid treatment and the urgent need for access to radiotherapy services especially in Africa where keloid prevalence is highest.

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Keloid disease: Review with clinical atlas. Part I: Definitions, history, epidemiology, clinics and diagnosis

Cited by 13 publications

References 51 publications

A role for vitamin D and the vitamin D receptor in keloid disorder

A role for vitamin D and the vitamin D receptor in keloid disorder

Keloid Scar Resistance to Intralesional Steroid Injections: Should We Look for Foreign Bodies? A Case Report

Massive facial keloid precipitated by chronic suppuration and mechanical skin traction: A case report

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