It is diagnosed from the clinical story (a slow-growing overgrowth of a scar, usually in a dark-skinned person), with the scar growing beyond the location of the original skin damage. From developing new therapies that treat and prevent disease to helping people in need, we are committed to improving health and well-being around the world. ) have been used to prevent keloid development or recurrence. Surgical or laser excision may debulk lesions, but they usually recur larger than before.
In the USA, a preparation containing 4 μg/cm2 flurandrenolide (a medium-strength steroid) is available. In Japan, two steroid tape formulations are available, namely, a 4 μg/cm2 fludroxycortide tape (medium-strength) and a 20 μg/cm2 deprodone propionate tape . In our experience, deprodone propionate tape is the most effective tape for the treatment and prevention of keloids. Imiquimod cream may help prevent keloids from forming after surgery. The cream may also prevent keloids from returning after they are removed.
The histology includes haphazardly arranged fascicles of hyalinized collagenous fibers with scattered fibroblasts and myofibroblasts. The proliferation is not encapsulated but blends subtly with the surrounding dermal fibrous tissue. The collagen bundles are often separated by dermal mucosubstances, creating an “edematous” appearance.
Diagnosis is based on the location and appearance of the scar, and how it progresses over time. Your doctor may do a physical exam and look at your medical and personal history to rule out any other possible diseases or conditions. A skin biopsy may be performed to confirm the diagnosis and to rule out any malignant tumor.
The size is variable, usually measuring less than 2 cm; however, they may attain a diameter of several centimeters. Histologically, keloids are characterized by thick, large, closely packed bundles of disorganized collagen.
Alpha smooth muscle actin is oriented around the vessel wall, and myofibroblasts are absent. Mucin is deposited focally in the dermis, and hyaluronic expression is confined to the thickened, granular/spinous layer. Steroid tape is available in the following three countries in slightly different preparations . In the UK, the commercially available formulation comprises a fludroxycortide-impregnated tape (4 μg/cm2).
A foreign body giant cell reaction is uncommon, except in patients treated with corticosteroid injection. Pools of amorphous mucin-like material may also be seen following steroid injection. Grossly, keloids are often polypoid and covered by thin, glistening, hairless skin.
Excision is more successful if preceded and followed by a series of intralesional corticosteroid injections. Gel sheeting (applying a soft, semiocclusive dressing made of cross-linked polymethylsiloxane polymer, or silicone) or pressure garments are other adjuncts to prevent recurrence.
Keloids are poorly vascularized with widely scattered dilated blood vessels. The overlying epidermis is thin and atrophic, without dermal adnexal structures.
Continue to follow these steps for at least 6 months after injury or surgery for an adults. Keloids can be diagnosed by your doctor or dermatologist .