Updates on keloid scar pathogenesis, assessment and treatment modalities

Elazhary, Engy; Al-Salam, Fatma Abd; Hafiz, Hala S A; Maghraby, Hala

doi:10.21608/jram.2021.82892.1123

Cited by 3 publications

(5 citation statements)

References 16 publications

(50 reference statements)

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“…7 Although the exact mechanism of compression therapy to prevent keloid recurrence is not understood, it acts through mechanoreceptor-induced apoptosis of cells in extracellular matrix where pressure-induced ischemia stimulates collagen degradation. 7,28 After keloid excision, a cavity is formed as if a mass has been removed from that area, and it is inevitable that fibrosis will occur in the cavity formed. This fibrosis can turn into keloid again in predisposed patients.…”

Section: Discussionmentioning

confidence: 99%

“…Up to 80% of recurrence-free treatment has been achieved by applying compression after excision 7 . Although the exact mechanism of compression therapy to prevent keloid recurrence is not understood, it acts through mechanoreceptor-induced apoptosis of cells in extracellular matrix where pressure-induced ischemia stimulates collagen degradation 7,28 …”

Section: Discussionmentioning

confidence: 99%

“…Fifteen ear keloid patients who attended our center in 2021-2022 were included in the study. The outpatient clinic follow-up of the patients was done for a median (range) period of 21 (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28) months after the surgery.…”

Section: Methodsmentioning

confidence: 99%

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A Novel Method for Patients With Ear Keloid

Işık,

Yaşar,

Alagöz

2024

Ann Plast Surg

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Background Keloid is a dermal fibroproliferative disease unique to humans. Due to the ambiguity in its pathophysiology and the frequent recurrence of keloid, there is no clear consensus on the treatment of keloid and there are many treatment methods defined. In order to benefit from the positive effects of fat grafting on pathological scars, we applied fat grafting to patients who underwent keloid enucleation. Methods Fifteen ear keloid patients included in the study. All patients underwent the same surgical procedure by the same surgeon. Routine follow-ups and examinations were performed to evaluate the results and in addition, the Patient and Observer Scar Assessment Scale (POSAS) survey was used. Results In the study, 15 patients were followed for a median (IQR) period of 21 (13–28) months. No recurrence was observed in any patient during follow-up, which occurred for a median of 21 (13–28) months. In the questionnaire filled out by the patients, the preoperative median value was found to be 48 (IQR: 12), whereas the postoperative median value was found to be 14 (IQR: 8). According to the patients, there was a statistically significant (P < 0.05) positive improvement after surgery. Conclusions Historically, surgical procedures were avoided because the surgical recurrence rate was very high, but today, recurrence rates are decreasing with combined treatments. These treatment combinations may require more than one intervention and require frequent clinical follow-ups. With our technique of fat grafting after enucleation, the treatment was completed with a single operation and no additional intervention was required.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Novel Method for Patients With Ear Keloid

Işık,

Yaşar,

Alagöz

2024

Ann Plast Surg

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“…A curved incision was used in our technique, which helped to reduce wound contraction during the healing period. Furthermore, a subcuticular suture can limit the numbers of keloids and hypertrophic scars, as skin sutures are more likely to cause irritation and inflammation compared to subdermal sutures 35 . Using a scrupulous surgical technique, iatrogenic keloid scarring can be minimized.…”

Section: Discussionmentioning

confidence: 99%

Donor site morbidities of concha cartilage harvesting using a retroauricular approach for cleft rhinoplasty: retrospective study

Themkumkwun,

Vorakulpipat,

Boonsiriseth

2023

JKAOMS

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Cleft lip and palate (CLP) are common deformities in the oral and maxillofacial regions. Cleft lip (CL) is found with or without cleft palate (CP) in 1 in 1,000 newborns 1 . The incidence of isolated CP is approximately 1 in 2,500. CLP is becoming more common among Asians than among Caucasians and Africans. Children born with CLP can experience functional and esthetic problems throughout life if treatment is not completed at an appropriate early age. Cleft nasal deformity is one of the deformities observed in patients with CLP. In addition to facial aesthetic issues, CLP patients also have dif-ficulty breathing 2 . Septorhinoplasty is recommended for cleft nasal deformities. Secondary rhinoplasty is one of the most challenging surgical procedures due to the severe anatomical distortions and scarring from previous surgeries [3][4][5] .Various materials are used to reconstruct the nasal form among patients with clefts, such as autologous cartilage, silicone implants 6 , and expanded polytetrafluoroethylene 7 . Polymer-based alloplastic material is associated with a higher rate of complications. Additionally, postoperative infection and material extrusion have been documented 8 . In contrast, surgeons favor autologous cartilage grafts for cleft rhinoplasty because their use is associated with fewer postoperative complications. Concha cartilage, septal cartilage, and costal cartilage are all used for cleft rhinoplasty. Concha cartilage has several advantages over the other choices: it is easy to harvest and sculpt and can provide enough quantity to reconstruct cleft nasal deformities [9][10][11][12] . The absence of visible scars at the donor site has been cited with all approaches, especially when using a retroauricular approach 13 . Although the concha cartilage is widely used, complications at the donor site have not been extensively reported, particularly with

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“…After it begins, a keloid tends to grow slowly for months or years. The first sign is usually a thickening of the skin [ 26 , 27 ]. The study results also showed that post-acne keloid patients were mostly pruritic.…”

Section: Discussionmentioning

confidence: 99%

Association Between Sebum, Total Cholesterol, and Low-Density Lipoprotein (LDL) Cholesterol Levels With Post-acne Keloids

Kurniawati,

Rodian,

Argentina

et al. 2023

Cureus

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Background Prolonged acne inflammation causes scar formation, one of which is post-acne keloids. Sebum, total cholesterol, and low-density lipoprotein (LDL) level can influence post-acne keloids. This study aims to determine the association between sebum, total cholesterol, and LDL levels with post-acne keloids to better define the predisposing factors for this condition. Methods This study used primary data involving sociodemographics, clinical features, keloid classification, sebum levels, total cholesterol levels, and LDL levels in post-acne keloid patients at the Dermatology, Venereology, and Aesthetics Outpatient Clinics of Dr. Mohammad Hoesin General Hospital Palembang, Indonesia. Study samples were patients who fulfilled the inclusion and exclusion criteria by consecutive sampling. The data then underwent univariate and bivariate analyses to show the association between variables. Result A total of 22 patients with post-acne keloids participated. The subjects presented mostly with major keloids based on the classification (59.1%). The patients were predominantly 21-30 years old (50%) and male (90.9%). The keloids had onsets >six months to one year (45.5%), durations of one to five years (77.3%), and multiple presentations (68.2%). Vancouver Scar Scale (VSS) assessment showed mainly red vascularity (40.9%), mixed pigmentation (68.2%), >5 mm keloid height (59.1%), and firm pliability (40.9%). Most patients presented with pruritus (86.4%) but without pain (54.5%). Most had low levels of sebum (50%), normal total cholesterol (90.9%), and near-optimal LDL level (40.9%). There were no significant association between sebum (p = 1.000), total cholesterol (p = 1.000), and LDL (p = 0.376) levels with post-acne keloids. However, LDL levels above normal were most found in this study (68.2%). Conclusions There is no association between sebum, total cholesterol, and LDL levels with post-acne keloids. Despite the fact that LDL level was not statistically significant, there has been a rise in LDL level in the research subjects. Further research with a larger number of subjects and consideration of multicenter study through retrospective/prospective methods and complete lipid profile examinations is still required to provide a more representative study.

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Updates on keloid scar pathogenesis, assessment and treatment modalities

Cited by 3 publications

References 16 publications

A Novel Method for Patients With Ear Keloid

A Novel Method for Patients With Ear Keloid

Donor site morbidities of concha cartilage harvesting using a retroauricular approach for cleft rhinoplasty: retrospective study

Association Between Sebum, Total Cholesterol, and Low-Density Lipoprotein (LDL) Cholesterol Levels With Post-acne Keloids

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