Keloids are more likely to develop on the arms, back, ears, lower legs, mid-chest, and neck. They may form as a wound heals, or they may take several months or even years to develop. Whether a patient needs preventive care or advanced treatment, a team-approach from keloid experts can deliver the best results.
Researchers think there might be genetic factors associated with keloid scarring, and we are on the cutting-edge of this developing field of study. UT Southwestern isbuilding a databaseof patient information to help determine whether there are genetic components related to keloid scarring. Keloids are the result of excessive collagen production and can produce an ‘overhealing’ effect that results in excessive scar tissue. In normal wound healing, there is a balance between new tissue biosynthesis and tissue degradation.
A typical regimen is 300 Gy every other day for 4 days or 500 Gy every day for 3 days, starting the day of surgery. Postoperative radiation is just as effective as combination preoperative and postoperative radiation.
Then, the frequency is adjusted according to response. Small keloids usually require 5-10 total injections given weekly. The most effective time to give radiation therapy is during the first 2 weeks after excision, while fibroblasts are proliferating.
To visit with a specialist, call orrequest an appointment online. Right now, the only way we know for sure whether a patient keloids is if they come to see us with one. However, individuals who develop keloids in one area of the body might never get them in another. The general rule is if a patient keloids on the chest, shoulders, or back, they might be more likely to keloid on the stomach, arms, scalp, and elsewhere.
Regions of the human genome highly correlated with keloid formation in 2 pedigrees with familial keloids have been identified. The regions identified were in 2 separate, unrelated locations on the human genome, underscoring the complex and multivariable pathogenesis of this disease.
This is achieved through the processes of apoptosis and remodelling of the extracellular matrix . They can develop after very minor skin damage, such as an acne spot or a piercing, and spread beyond the original area of skin damage. Bux S, Madaree A. Involvement of upper torso stress amplification, tissue compression and distortion in the pathogenesis of keloids.
Today, researchers have a small amount of data for East Asian ethnicities andone genehas been identified in one Nigerian family as potentially associated with keloids. Over time, we hope to amass enough data to sort by patient demographics such as ethnicity to provide clues as to why certain populations are more prone to developing the condition.
Methotrexate has proven quite successful in preventing recurrences when combined with excision. Dosing is mg given in a single dose every 4 days, starting a week before surgery and continuing for 3 months. 5-fluorouracil (5-FU) injected intralesionally has been successfully used to treat small keloids. A mixture of 0.1 mL of triamcinolone acetonide (10 mg/mL) with 0.9 mL of 5-FU (50 mg/mL) produces the best results. It is injected into the keloid 3 times per week initially.