Epidemiology of keloids in normally pigmented Africans and African people with albinism: population-based cross-sectional survey

Kiprono, Samson; Chaula, Baraka; Masenga, J.E.; Muchunu, J.W.; Mavura, Daudi; Moehrle, Matthias

doi:10.1111/bjd.13826

Cited by 45 publications

(34 citation statements)

References 10 publications

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“…In Asian, African and Caucasian countries, the keloid incidence ranges are 0–0.1%, < 0.1, and 5–10%. 24–28 However, we do not think that African patients should be treated by high-dose radiation while Caucasian patients should be treated by low-dose radiation. This is because keloid is the result of chronic inflammation of the dermis 2 and radiation therapy after extirpation of the keloid aims to suppress any new emergence of this inflammation.…”

Section: Customisation Of Our Protocol With Regard To Racial Differencesmentioning

confidence: 99%

Surgical excision and postoperative radiotherapy for keloids

Ogawa

Tosa

Dohi

et al. 2019

Scars, Burns & Healing

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Keloids can be treated in a number of ways, including by surgery. Multiple studies now show that while surgical monotherapy associates with extremely high rates of recurrence (50%–80%), postoperative radiotherapy can significantly reduce these recurrence rates. Ongoing improvements in radiation technology have further increased the safety and efficacy of this combination protocol. Of the various radiotherapies that have been used in this setting, electron beam (β-ray) irradiation is currently the best due to its excellent dose distribution and safety. The maximal biologically effective dose (BED) for keloids is 30 Gy (using an estimated α / β ratio of 10); increasing the dose has no further benefits and elevates side effects. Over the last two decades, we have modified and then fine-tuned our radiotherapy protocol for keloid excision wounds. Thus, our early protocol was used for all body sites and consisted of 15 Gy/3 fr/3 days. We then customised the radiotherapy protocol so that body sites that are highly prone to recurrence (e.g. the anterior chest) receive higher doses while low recurrence sites like the earlobe receive a much smaller dose. More recently, we tweaked this body site-customised protocol so that fewer fractions are employed. Therefore, we currently apply 18 Gy/3 fr/3 days to high-recurrence sites, 8 Gy/1 fr/1 day to earlobes and 15 Gy/2 fr/2 days to other body sites. These radiotherapy protocol changes were accompanied by the evolution of body site-customised surgical approaches. As a result of these developments, our overall keloid recurrence rate is now below 10%.

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Section: Customisation Of Our Protocol With Regard To Racial Differencesmentioning

confidence: 99%

Surgical excision and postoperative radiotherapy for keloids

Ogawa

Tosa

Dohi

et al. 2019

Scars, Burns & Healing

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“…For them, the total prevalence of keloid was 8.3%. The subjects with normal pigmentation did not differ significantly from the subjects with albinism in terms of keloid prevalence (8.5% versus 7.8%; P = 0.599) [5]. The Epidemiology of Keloids the ethnicities of the keloid patient cohort showed that keloid was more common in the relatively fair-skinned Chinese: while 56% of the keloid patients were Chinese, this ethnicity accounted for only 47.47% of the population.…”

Section: Demographic Risk Factors That Shape Keloid Ratesmentioning

confidence: 88%

“…Thus, keloids accounted for nearly 9% of all those surgical cases in Zambia during the study period [4]. Moreover in Kenya, the keloid prevalence is 8.5% among people with normally pigmented skins [5]. By contrast, the keloid incidence in Japan is around 0.1% [6] (.…”

Section: Demographic Risk Factors That Shape Keloid Ratesmentioning

confidence: 99%

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The Epidemiology of Keloids

Huang

et al. 2020

Textbook on Scar Management

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Keloids are pathological scars that are characterized histologically by an overwhelming aggregation of fibroblasts and collagen type I within the inflammatory reticular dermis. Their clinical characteristics include continuous growth and invasion into the neighboring healthy skin beyond the original wound boundary via an erythematous and pruritic leading edge. They also show a strong tendency to recur when they are surgically excised in the absence of adjuvant therapies. Despite the fact that keloids are common throughout the world, their epidemiology has not been adequately investigated. In this chapter, we will summarize the limited epidemiological data on keloids that exists to date in terms of: (1) the demographic distribution of keloids, mainly on the geographical regions and ethnic racies; (2) the internal genetic factors that shape keloid rates; and (3) the external environmental factors that influence keloid epidemiology. The aim of the chapter is to facilitate a greater understanding of the complexity and diversity of keloids from an epidemiological perspective, thereby potentiating further and deeper explorations into individualized strategies that prevent and treat keloids.

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“…Распространенность гипертрофических и келоидных рубцов кожи в общей популяции составляет от 4,5 до 16% в разных регионах мира [1,2]. Подсчитано, что каждый год у 100 млн человек в мире появляются шрамы после травм и хирургических вмешательств, и 15 млн из них будут иметь неэстетические или гипертрофические и келоидные рубцы [3].…”

Section: Introductionunclassified