Should Excised Keloid Scars Be Sent for Routine Histologic Analysis?

Gulamhuseinwala, Nadim; Mackey, Simon; Meagher, Peter; Powell, Barry

doi:10.1097/sap.0b013e318056d6cc

Cited by 13 publications

(20 citation statements)

References 12 publications

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“…18 However, this current study has shown that detailed histopathologic reporting on keloid scars may be important, with specific reporting of surgical excision margins and border characteristics as these are possible indicators of clinical prognosis.…”

Section: Discussionmentioning

confidence: 94%

The Influence of Surgical Excision Margins on Keloid Prognosis

Tan¹,

Shah²,

Pritchard³

et al. 2010

Annals of Plastic Surgery

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Keloid disease is known to have variable clinical behavior in response to therapy and there is no clinicopathologic classification that predicts such varied behavior. The aim of this study was to study the effect of excision margins and other histopathologic characteristics on keloid prognosis.Seventy-five multiethnic patients presenting with keloid scars at a department of plastic and reconstructive surgery during an 11-year period were included in this study. Clinical data was collected and detailed histologic analyses using light microscopy were carried out on archived patient specimens.A detailed histopathologic examination of all tissue samples identified keloid border or margin characteristics which were classified into "circumscribed" (borders clearly-demarcated) and "infiltrative" (borders not clearly-demarcated and not easily-definable). The specific histologic findings were correlated with keloid recurrence which revealed that incomplete peripheral (P < 0.001) and deep excision margins (P < 0.001), as well as infiltrative borders (P < 0.05) were associated with higher 1-year reported recurrence rates.This study has given evidence that incomplete surgical excision are associated with higher recurrence and this may justify the practice of routine histopathologic reporting of keloid excision margins.

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Section: Discussionmentioning

confidence: 94%

The Influence of Surgical Excision Margins on Keloid Prognosis

Tan¹,

Shah²,

Pritchard³

et al. 2010

Annals of Plastic Surgery

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“…by Gulamhuseinwala et al 1 and the letter that was sent by Wong et al in response to this article. 2 Gulamhuseinwala et al.…”

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confidence: 85%

“…2 Gulamhuseinwala et al. 1 reported their pathologic analyses of 568 scars, of which 458 (81%) were classified as "keloids," 60 (11%) as "acne keloidalis," 35 (6%) as "hypertrophic scars (HSs)," and 14 (2%) as "normal scars." There were no reported malignancies or dysplasias.…”

mentioning

confidence: 99%

Histologic Analysis of Keloids and Hypertrophic Scars

Ogawa

Akaishi

Izumi

2009

Annals of Plastic Surgery

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“…One of the most important indicative information that leads to keloid scar diagnosis is the history of some form of injury prior to the appearance of the lesion [7]. Spontaneous keloid scars, that is, those keloidal lesions that develop without previous injury or surgery, are rare [8].…”

Section: Introductionmentioning

confidence: 99%

Challenging Diagnosis of a Rare Case of Spontaneous Keloid Scar

Tiong

2014

J Med Cases

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Keloid scars are benign dermal collagenous lesions that arise in the reticular layer of the dermis as a result of a period of prolonged wound healing due to injurious cutaneous insult. It is diagnosed clinically by a history of injury preceding its appearance and its pathognomonic encroachment beyond the boundary of the original wound. There are multiple factors that predispose an individual to keloid scar formation but no single hypothesis sufficiently explained its complex pathogenesis. The spontaneity of keloid scar to arise de novo without prior cutaneous injury is very rare. Although the non-specific appearance of spontaneous keloid scar can resemble various malignant or benign tumors, it is of paramount importance to accurately diagnose it due to the difficulty and complexity of keloid scar treatment or the atrocious outcome of its mismanagement. Here, we presented a rare case of spontaneous keloid scar over an unusual site of occurrence, and its disfiguring consequences as a result of misdiagnosis and treatment. We also highlighted the diagnostic challenge facing many clinicians when spontaneous keloid scar occurred in an individual without significant predisposing factors. Therefore, extra vigilance should be exercised in our practice and the spontaneity origin of keloid scar should be borne in one's mind.

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Should Excised Keloid Scars Be Sent for Routine Histologic Analysis?

Abstract: These histology results suggest that, given a good clinical suspicion of keloid, it may be unnecessary to send specimens at excision for routine histology.

Cited by 13 publications

References 12 publications

The Influence of Surgical Excision Margins on Keloid Prognosis

The Influence of Surgical Excision Margins on Keloid Prognosis

Histologic Analysis of Keloids and Hypertrophic Scars

Challenging Diagnosis of a Rare Case of Spontaneous Keloid Scar

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