Keloid

Alibert, 1816

Bead scar, scar proliferation, scar keloid.

Enlarged scar due to connective tissue proliferation (collagen type I).

• Especially young adults
• Increased risk with the following geographical origin
  • Africans (up to 20-fold higher incidence compared to Caucasians)
  • Asians

• After trauma or spontaneously
• Increased collagen synthesis (structural proteins are replaced mainly by collagen type I)

• Especially in the face, pre-sternally, and on the upper arms, there are exophytic, hypertrophic, skin-coloured, coarse palpable, sharply delimited, plate-like or nodular bulges, often with telangiectasia
• Loss of hair
• Unlike a hypertrophic scar, the keloid extends beyond its original boundaries

• Clinical
• Biopsy to delineate differential diagnoses, if necessary

Trunk, face, upper arms.

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3. Berman B, Duncan MR. Short-term keloid treatment in vivo with human interferon alfa-2b results in a selective and persistent normalization of keloidal fibroblast collagen, glycosaminoglycan, and collagenase production in vitro. Journal of the American Academy of Dermatology 1989;21:694-702. 
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9. Berman B, Flores F. Comparison of a Silicone Gel-Filled Cushion and Silicon Gel Sheeting for the Treatment of Hypertrophic or Keloid Scars. Dermatologic Surgery 1999;25:484-6. 
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16. Treatment of keloid scars post–shave excision with imiquimod 5% cream: A prospective, double-blind, placebo-controlled pilot study. Journal of the American Academy of Dermatology 2008;58:AB10. 
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18. Smith JC, Boone BE, Opalenik SR, Williams SM, Russell SB. Gene Profiling of Keloid Fibroblasts Shows Altered Expression in Multiple Fibrosis-Associated Pathways. Journal of Investigative Dermatology 2008;128:1298-310. 
19. Ikeda M, Naitoh M, Kubota H, et al. Elastic fiber assembly is disrupted by excessive accumulation of chondroitin sulfate in the human dermal fibrotic disease, keloid. Biochemical and Biophysical Research Communications 2009;390:1221-8. 
20. Ogawa R, Yoshitatsu S, Yoshida K, Miyashita T. Is Radiation Therapy for Keloids Acceptable? The Risk of Radiation-Induced Carcinogenesis. Plastic and Reconstructive Surgery 2009;124:1196-201. 
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