Vascular Endothelial Growth Factor and Connective Tissue Growth Factor are over expressed in keloid tissue and may have a potential role in its evolution . It begins around the third day after injury, lasts for 2 to 3 weeks. The aim of this phase is to restore the function of injured tissue, through reepithelialization, neovascularization, fibroplasia.
Hemostasis is the process that responds to injury to stop blood loss by vascular and cellular responses. The increased blood flow, triggering the signs of inflammation, such as heat, edema and redness. Platelets aggregate at the site of injury, leading to blood clot . Blood clot is temporarily seal the bleeding, and acts as a reservoir for growth factors and cytokines, and cell migration. Blood clots predominantly consist of fibrin, but other Extracellular Matrix proteins, such as fibronectin, vitronectin, and thrombospondin, are also present.
reported a recurrence rate of 40% following simple surgical resection. Interestingly, keloids only occur in humans and no keloid animal model exists.
The broad variability in shape, size, and location is most likely due to underlying complex genetic abnormalities. In advanced stages, keloid lesions can appear as large skin nodules, as a conglomerate of nodules, or as massive skin tumours and large keloid patches. In addition to its often unpleasant appearance, a keloid lesion can cause pain, itching, and a burning sensation. Massive keloids seen on both arms and on the thoracic wall in a patient at the Dermatology Clinic, Cheikh Anta Diop University Hospital, Dakar, Senegal. The authors visited the hospital during an exchange visit between Lund University and Dakar, when PDT also was performed at the same hospital .
They are also more likely in people who are aged years old. Henriquez CB, Costa F. Resident’s Thesis Systematization of treatment of keloid at the Plastic Surgery Unit of the 38th Infirmary of Santa Casa de Misericórdia do Rio de Janeiro. 1-Take proper precautions in surgical patients of black and Western races.
Normally when the skin is damaged, fresh skin is laid down to heal the damage but then the damaged area you see gradually fades away (the medical term for this process is ‘involution’). When first coined in 1806, the original term was ‘chéloïde’, taken from the Greek word ‘chele’ which means crab’s claw. This refers to the way the keloid grows sideways into the normal skin. This photo shows keloids on the ear and beard area after dog bite injuries. Keloids are smooth overgrowths of fibroblastic tissue that arise in an area of injury or, occasionally, spontaneously.
consistency, was reduced by 40% and the skin synechia became smaller. The antiangiogenic factors, including the Vascular Endothelial Growth Factor inhibitors (e.g. Bevacizumab). Phototherapy (photodynamic therapy – PDT), UVA-1 therapy, narrow band UVB therapy. Recombinant human interleukin (rhIL- 10) which are directed at decreasing collagen synthesis . Usually occurs within 4 to 8 weeks following wound, has a rapid growth phase for up to 6 months, and then gradually regresses over a period of a few years.
3-Proper and effective treatment for acne and other inflammatory lesions. Synechia disappeared and the keloid was reabsorbed at 15 days after the last cortisone infiltration. The patient did not show any recurrence of the lesion at the 6- month and 12- month follow-up visits .
Possible involvements of fibrin and fibronectin in keloid pathogenesis have been suggested . The goal of this phase is to remove injured tissue and foreign bodies from the wound and restore immunological control. This phase begins immediately after the occurrence of trauma, and continues for 4-6 days. Patient does not provide medical advice, diagnosis or treatment. Then, instead of simply fading away, the scar tissue just stays where it is.
6-Patients with suprapubic scars should use post-operative braces and foam compression. 4-For patients with wounds on the earlobes, choose adequate pillows and covers to avoid rubbing the wound while lying.
Keloids can appear as single small spots on the skin, or they can affect several areas of the skin. They can be either round or linear, and they can spread to wider areas.
The doctor will ask about your symptoms and health history. Your answers and a physical exam may point to a keloid. Keloids are more common in people who are Black, Asian, or Hispanic.