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The authors have indicated no significant interest with commercial supporters.O ver a 6-year period, we collected data from 256 keloid lesions from 192 patients. The patients were collected from the Barts and The London National Health Service Trust catchment area in East London and the City of London, United Kingdom, and all 192 patients were referred from hospital-based surgical specialties and dermatology to our specialist keloid clinic. In our keloid clinic, we treat patients only aged 16 and older who have keloids that have been referred for intralesional steroid therapy administered by one keloid nurse specialist 1 .The data were studied on the basis of the size of the keloids, the site of the keloids, low-dose steroid therapy, high-dose steroid therapy, and three types of combination steroid therapy. 3Of the 256 keloids studied, earlobe and sternal keloids were by far the most common sites affected, but the back of the head and the occipital area had keloids with the largest mean surface area (422 cm 2 ) (Figure 1).The nonbearded area of the face had a mean dose of steroid injection of 8.75 mg by the end of treatment with no recurrence. Likewise, the bearded area had a mean dose of 20.37 mg, with a 33% chance of recurrence, the upper limbs 21.91 mg with 20% recurrence, the earlobes 16.38 mg with 10% recurrence, the occipital area of the head 18.29 mg with 0% recurrence, and the sternum 35.77 mg with a 16% recurrence rate ( Figure 2).After treatment in our keloid clinic, 43% of patients were discharged with no recurrence, 7.3% returned for further injections, 5% went on to have excision surgery, 8% went on to have camouflage treatment, 2 28% were partially treated and declined further treatment after steroid therapy, 3% were discharged fully treated with pressure earrings, 1 6 2 4 E a r l o b e S t e r n u m / c h e s t / b r e a s t U p p e r l i m b / s h o u l d e r / a x i l l a B e a r d a r e a O t h e r s B a c k o f h e a d F a c e n o n b e a r d a r e a 0 1.3 8.4 7.7 4.6 Site Mean size vs Keloid Mean surface area (cm2) 7.8 22.2 1.5 5 10 15 20 25 Figure 1. Mean size and site of the keloids.

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