This document summarizes the characteristics and treatment of keloids. Keloids are firm, irregularly shaped growths that extend beyond the site of an injury. They most commonly occur on the chest and ears. Keloids are more common and grow larger in black persons. Initial treatment involves intralesional injections of corticosteroids alone or with other agents like 5-FU or verapamil. Surgical removal may also be used. Chemotherapeutic agents and verapamil help reduce fibroblast proliferation and scarring.

1. Dr.Alaa Mohammad AbuZaineh
Teaching Assistant
RAKCOMS
RAKMHSU

3. Keloids
• firm, irregularly shaped, fibrous,
hyperpigmented, pink or red
excrescence.
• The growth usually arises as the
result of a cut, laceration, or burn—
or less often an acne pustule on the
chest or upper back—and spreads
beyond the limits of the original
injury, often sending out clawlike
(cheloid) prolongations.
• The overlying epidermis is smooth,
glossy, and thinned from pressure

4. • Location
• most common  sternal region
• but keloids also occur frequently on the neck, ears (earlobes mostly as a
result of ear piercing) , extremities, or trunk
• rarely  face, palms, or soles.
• more common and grow to larger dimensions in black persons than
others.
• Lesions may be tender, painful, and pruritic and may rarely ulcerate or
develop draining sinus tracts.
• Atypical lesions should be biopsied because carcinoma en cuirasse
may mimic keloid

5. Keloids Vs Hypertrophic Scars
Keloid Hypertrophic scar
clawlike projections Present Absent
Extension beyond the confines of the original injury Present Absent
presence of thick, hyalinized collagen bundles histologically Present Absent
spontaneous improvement Absent Frequent

6. Treatment
• Initial Tx  intralesional injection of triamcinolone (Corticosteroid)
alone or in combination with 5-fluorouracil (5-FU), methotrexate,
verapamil, and/or lasers
• Chemotherapeutic agents Inhibits fibroblastic proliferation in tissue culture and is believed to reduce postoperative scarring by
decreasing fibroblast proliferation.
• Verapamil has been proven to increase the synthesis of procollagenase in keloids, hypertrophic scars, and normal cultured
fibroblasts.
• surgical removal

7. Thank You
• Reference :
• William James, Dirk Elston, James Treat, Misha Rosenbach, Isaac Neuhaus -
Andrews’ Diseases of the Skin_ Clinical Dermatology-Elsevier (2019)