Keloids: clinical features and management. Part II
Keywords:
Keloids are benign tumours of fibrous origin which clinically present as firm, flesh-coloured tumours. The exact etiology is not known, nevertheless, there are many associated dermatoses. Therapeutically, keloids are a challenging disease and no single efAbstract
Keloids are benign tumours of fibrous origin which clinically present as firm, flesh-coloured tumours. The exact etiology is not known; nevertheless, there are many associated dermatoses. Therapeutically, keloids are a challenging disease and no single effective therapy is available. The present review presents the clinical features and therapeutic update of this common malady.ÂReferences
Shaffer JJ, Taylor SC, Cook-Bolden F. Keloidal scars: a review with a critical look at therapeutic options. J Am Acad Dermatol 2002; 46: 63-97.
Murray JC. Scars and keloid. Dermatol Clin 1993; 11: 697-708.
Porter JP. Treatment of the keloid. What is new? Otolarg Clin North Am 2002; 35: 207-20.
Brian B, Bieley HC. Keloids. J Am Acad Dermatol 1995; 33: 117-23.
Gold MH. A controlled clinical trial of topical silicone gel sheeting in the treatment of hypertrophic scars and keloids. J Am Acad Dermatol 1994; 30: 56-7.
Niessen FB, Spauwen PHM, Robinson PH et al. The use of silicone occlusive sheeting (silk) and silicone occlusive gel (epiderm) in the prevention of hypertrophic scar formation. Plast Recons Surg 1998; 102: 1962-3.
Eishi K, Bae SJ, Ogawa F et al. Silicone gel sheets relieve pain and pruritus with clinical improvement of keloid: Possible target of mast cells. J Dermatol Treat 2003; 14: 248-52.
Rayner K. The use of pressure therapy to treat hypertrophic scarring. J Wound Care 2000; 9: 151-3.
Puzey G. The use of pressure garments on hypertrophic scars. J Tissue Viability 2002; 12: 11-5.
Yosipovitch DG, Sugeng MWY, Goon A. A comparative study of combination intralesional corticosteroid with cryotherapy versus intralesional corticosteroid and cryotherapy alone in the treatment of keloids in adolescents. NSC Bul 2000; 11: 1-5.
Tang YW. Intra and postoperative steroid injections for keloids and hypertrophic scars. Br J Plast Surg 1992; 45: 371-9.
Young KC, Susan R, Gustave M et al. Major suppression of pro- (I) type I collagen gene expression in the dermis after keloid excision and immediate intrawound injection of triamcinolone acetonide. J Am Acad Dermatol 1997; 37: 586-9.
Kuflik EG. Cryosurgery updated. J Am Acad Dermatol 1994; 31: 925-44.
Zouboulis CC, Blume U, Bultner P, Orfanos CE. Outcomes of cryosurgery in keloids and hypertrophic scars. Arch Dermatol 1993; 130: 1146.
Heidenhein M, Jemec GBE. Side effects of cryosurgery. J Am Acad Dermatol 1991; 24: 653-6.
Katz BE. Dermabrasion for scar revision. In: Roenigk RK, Roenigk HH, eds. Surgical Dermatology Advances in Current Practice. London: Martin Dunitz; 1993.
Berman B, Bieley HC. Adjunct therapies to surgical management of keloids. Dermatol Surg 1996; 22: 126-9.
Ship AG, Weiss PR, Mincer FR, Wolkstein W. Sternal keloids: Successful treatment employing surgery and adjunctive radiation. Ann Plast Surg 1993; 31: 481-7.
Ferguson G. Intralesional steroid injection following keloid surgery. Plast Recons Surg 1994; 93: 643-5.
Escarmant P, Zimmermann S, Amar A et al. The treatment of 783 keloid scars by irradiation. Int J Radial Oncol Biol Phys 1993; 26: 245-59.
Norris JE. Superficial X-ray therapy in keloid management. Plast Reconstr Surg 1995; 95: 1051-6.
Durosimmi FA, Olasinde TA, Solarin EO. A short course of postoperative radiotherapy regime for keloid scars in Nigeria. West Afr J Med 1994; 13: 17-23.
Lo TC, Seckel BR, Salzman FA, Wright KA. Single dose electron beam irradiation in treatment and prevention of keloids and hypertrophic scars. Radiother Oncol 1990; 19: 267.
Cheng ET, Pollard JD, Koch FJ. Effect of blended CO2 and erbium:YAG laser irradiation on normal and keloid fibroblasts. J Clin Laser Med Surg 2003; 21: 337-43.
Norris JE. The effect of CO2 laser surgery on the recurrence of keloids. Plast Recons Surg 1991; 87: 44-63.
Goldman MP, Fitzpatrick RE. Laser treatment of scars. Dermatol Surg 1995; 8: 685.
Connell PG, Harland CC. Treatment of keloid scars with pulsed dye laser and intralesional steroid. J Cutan Laser Ther 2000; 2: 147-50.
Asawanonda P, Khoo LSW, Fitzpatrick TB, Taylor CR. UV-AI for keloid. Arch Dermatol 1999; 135: 348-9.
Uppal RS, Khan U, Kakar S, Talas G, Chamman P. The effects of a single dose of 5-fluorouracil on keloid scars: a clinical trial of timed wound irrigation after extralesional excision. Plast Recons Surg 2001; 108: 1218-24.
Kontochristopoulos G, Stefanaki C, Panagiotopoulos A et al. Intralesional 5-fluorouracil in the treatment of keloids: an open clinical and histopathologic study. J Am Acad Dermatol 2005; 52: 474-9.
Bodokh I, Burn P. Treatment of keloid with intralesional bleomycin. Ann Dermatol Venereol 1996; 123: 791-4.
Castaings PMH. Retinoic acid in the treatment of keloids. J Dermatol Surg Oncol 1988; 11: 1275.
Burton JL, Lovell CR. Disorders of connective tissue. In: Champion RH, Burton JL, Burns DA, Breathnach SM, eds. Textbook of Dermatology. Oxford: Blackwell Science, 1998. p. 2003-71.
Larrabee WF, East CA, Jaffe HS et al. Intralesional interferon gamma treatment for keloids and hypertrophic scars. Arch Otolaryng Head Neck Surg 1990; 116: 1159-62.
Berman B, Villa A. Imiquimod 5% cream for keloid management. Dermatol Surg 2003;29:1050-1.
Phan TT, Sec P, Tran E, Ngoyent TT, Chan SY, Huynh H. Suppression of Insulin-like growth factor signalling pathway and collagen expression in keloid-derived fibroblasts by quercetin, its therapeutic potential use in the treatment and/or prevention of keloids. Br J Dermatol 2003; 148: 544-52.