Clinical Analysis of Lobular Keloid after Ear Piercing

Abstract

BackgroundLobular keloid appears to be a consequence of hypertrophic inflammation secondary to ear piercings performed under unsterile conditions. We wish to understand the pathogenesis of lobular keloids and report operative outcomes with a literature review.MethodsA retrospective review identified 40 cases of lobular keloids between January, 2005 and December, 2010. Patient records were reviewed for preclinical factors such as presence of inflammation after ear piercing prior to keloid development, surgical management, and histopathologic correlation to recurrence.ResultsThe operation had been performed by surgical core extirpation or simple excision, postoperative lobular compression, and scar ointments. Perivascular infiltration was noted in intra- and extra-keloid tissue in 70% of patients. The postoperative recurrence rate was 10%, and most of the patients satisfied with treatment outcomes.ConclusionHistological perivascular inflammation is a prominent feature of lobular keloids. Proper surgical treatment, adjuvant treatments, and persistent follow-up observation were sufficient in maintaining a relatively low rates of recurrence.

Infected auricular keloid secondary to attempted self-amputation of a gauge earring

“…Keloid formation after earring placement may be predisposed by extrinsic trauma to the region, allergies to earring materials, infection due to non-sterile piercing conditions or otherwise, mechanical force from contact with a pillow during sleep, and the weight of the earring. [2][3][4][5] It is unclear of the predisposing history in this patient's case of keloid scarring; however, poor healthcare-literacy as evidenced by attempted self-amputation of the scar likely contributed to the extent of keloid formation and necrosis seen. Additionally, incarcerated and formerly incarcerated populations may present at later disease stages and often have lower levels of health literacy than the free world population.…”

Surgical Core Excision With Tongue Flap Closure in Combination With Electron Beam Radiotherapy in the Treatment of Ear Keloids

“…3–5 Keloids are commonly found in dark skin populations and people with a family history of keloid, but less commonly, they can be found in Asian and Western populations. 6…”

“…[3][4][5] Keloids are commonly found in dark skin populations and people with a family history of keloid, but less commonly, they can be found in Asian and Western populations. 6 The earlobe is one of the most common body sites where keloid formation is observed. 7 The most common cause of ear keloid is ear piercing; however, rarely, it can be caused by acne, drainage of auricular hematomas, skin infection, insect bites, or burn injuries.…”