Keloids Can Be Forced Into Remission With Surgical Excision and Radiation, Followed by Adjuvant Therapy

Abstract

We have treated keloids using a combination of surgical excision and postoperative irradiation. The objective of this study was to evaluate the results of our treatment over 12 years. From 1995 until 2006, we treated keloids using the aforementioned treatment. If we identified a sign of recurrence during the follow-up period, we started an intralesional injection of triamcinolone acetonide immediately. We selected 91 keloids for which we had more than 2 years of follow-up data for this study and assessed the results according to our original scale (Kyoto scar scale) based on objective and subjective symptoms. In all, 51 keloids (56.0%) were cured completely by a combination of surgical excision and postoperative irradiation without additional treatment, and finally 81 keloids (89.0%) showed good results with additional treatment. Keloids are a controllable condition when treated with combination therapy, involving surgical excision with postoperative irradiation and early conservative treatment after the detection of recurrence.

Chondroitinase injection improves keloid pathology by reorganizing the extracellular matrix with regenerated elastic fibers

“…However, this method is not applicable for large or multiple keloids. Although surgical excision combined with postoperative radiotherapy is also a valuable modality for keloids, this method was not able to completely prevent recurrence . Keloid lesions contain a very high level of collagen fibers and this extracellular matrix protein was considered to be a target for keloid treatment.…”

“…Although surgical excision combined with postoperative radiotherapy is also a valuable modality for keloids, this method was not able to completely prevent recurrence. 19 Keloid lesions contain a very high level of collagen fibers [2][3][4] and this extracellular matrix protein was considered to be a target for keloid treatment. However, Kang et al 20 reported that collagenase treatment was ineffective for keloid therapy.…”

A Toe Keloid after Syndactyly Release Treated with Surgical Excision and Intralesional Steroid Injection

“…We have previously treated keloids using surgical excision and postoperative irradiation as a standard treatment 9 ; however, the radiosensitivity of the children is so high that hypoplasia following foot irradiation is inevitable. Therefore, intralesional steroid injections were substituted for radiation treatment as an additional postoperative treatment in the present case.…”

“…Finally, 5 injections of triamcinolone acetonide over a period of 16 months brought about a complete cure. Onwukwe 9 reported the successful outcomes of using methotrexate in the treatment of keloids. Low-dose methotrexate is widely used for rheumatoid arthritis and is used in both adults and children.…”

HtrA1 Is Specifically Up-Regulated in Active Keloid Lesions and Stimulates Keloids Development

“…There are many treatments for keloids; steroid injections, steroid tape, surgery with postoperative irradiation and so on. Even if we carry out the operation and postoperative radiation to the keloid patients, the cure rate is 28~89% [3,[5][6][7][8], it depends on the individuals. To clarify the keloid pathogenesis will improve the treatments results.…”