Abnormal scarring in susceptible individuals.
More common in darker skin types.
Diagnosis is clinical.
Treatment results are very variable. First-line options include silicone gel, intralesional corticosteroids, and pressure therapy.
Surgery is reserved for patients who do not respond to medical therapy, and must be given with adjuvant pressure therapy, intralesional corticosteroids, or radiotherapy to prevent recurrence.
A keloid is an abnormal form of scarring (a fibroproliferative disorder); it is not associated with maturation, regression, or contraction.
History and exam
Key diagnostic factors
- presence of risk factors
- history of inciting event (e.g., body piercing, surgery, insect bite, vaccination)
- slow growth
- erythematous, smooth, and shiny elevated scar with overhanging edge
Other diagnostic factors
- itchiness, tingling, or pain
- history of prior keloid
- family history of keloid
- darker skin types
1st investigations to order
- clinical diagnosis
Investigations to consider
- skin biopsy
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