Literature review and case report of post-circumcision keloid management

Abstract

Keloid following circumcision has been described in the literature despite the rarity of its occurrence in penile skin. In this paper, we review the literature and report the successful management of post-circumcision keloid scarring in a 2-year-old boy. After circumcision a 2-year-old boy of African origin developed keloid scarring at the circumcision site. This was treated with three intralesional injections of triamcinolone acetate over 3 months, followed by surgical excision. There was no recurrence at 6 months after excision. To our knowledge this is the 12th case of keloid following paediatric circumcision described in the literature. There is a wide range of techniques described but all are recurrence free at 6 months following repeated intralesional triamcinolone acetate injection and surgical excision. While there is no current consensus in treating post-circumcision keloid, we find that intralesional injection followed by surgical excision provides an acceptable aesthetic result, which is recurrence free.

Penile Keloid Successfully Cured in a Keloid High-Tendency Patient

“…Keloid formation is most common in the ear lobule. However, it can be found in the upper chest, shoulders, upper back, head, and neck and rarely in the penis [7].…”

Massive recurrent penile keloid scar after neonatal circumcision: A case report

“…According to the literature, the most popular means of treating penile KS after circumcision has been excision followed by corticosteroid intralesional injections [3,8]. Penile KS post-circumcision have been reported in twenty different cases ranging from 1993 to 2020 with twelve of the patients receiving excision followed by intralesional steroid injections [4,24]. Only one case demonstrated recurrence; subsequently the patient underwent repeat excision with triamcinolone intralesional injections with no recurrence.…”

“…Four patients underwent intralesional triamcinolone injections only and one with excision only, all without recurrence [18,21,24]. There are also three studies that showed no demonstrated recurrence when intralesional injections were administered prior to surgical excision of the KS [4,22]. Of note, 20 percent of the study population had a prior history of KS formation.…”

“…Genital KS formation has been infrequently described, and no treatment protocol exists [3,4]. For KS occurring after circumcision, previously-described interventions include excision, steroid injections, radiation therapy, pressure dressings, and use of silicone sheeting.…”