The process by which keloid develop is poorly understood, but it is known to be induced by abnormal wound healing in predisposed individuals. There are several theories of keloid etiology, most of them are related to fibroblast dysfunction. Keloid fibroblasts, when compared with fibroblasts isolated from a normal wound, excessive deposition of extracellular matrix components, especially collagen, fibronectin, elastin, proteoglycans. In addition, these cells have higher rates of mitosis, and lower rates of apoptosis. There are several theories of keloid formation according to induced factor.
The condition can range from mildly annoying to socially limiting. Research suggests that keloids affect patients’ quality of life similarly to psoriasis. While some patients don’t mind their scars, others are very bothered by them, finding it impossible to camouflage facial keloids.
The therapy was quite effective, as the rate of no recurrence with significant flattening of the scar ranges from 51-74%. Cryotherapy used in combination with intralesional steroids has an even greater response rate, with objective success reported in 84% of patients. In the study, the recurrence rates for low-dose-rate and high-dose-rate therapy were 30.4% and 38%, respectively. Foot with keloid scar several months postoperatively .
We’ve found that patients in this group tend to be more proactive about using coverings, creams, and ointments on wounds and are generally more careful about avoiding injury. These patients also are less likely to get tattoos and piercings or undergo elective surgery.
Some of them implicate certain cytokines, other implicate keratinocyte. In contrast, some theories suggest that fibroblasts have the initial disorder. Science hasn’t yet managed to explain why some people go on to develop keloid scars after their skin is damaged, and others don’t. Other treatment options include surgery, laser therapy, corticosteroid injections, and compression dressings. Sheets of silicone gel may also be worn on the affected area.
Whether or not a keloid will form is not determined by the severity of the wound – even a minor skin abrasion can result in keloid formation. People usually develop them between the ages of 10 and 30. Keloids below the elbow are knee are relatively rare. Patients who keloid in these areas should assume that any surgery, cut, or inflammation will likely trigger a keloid.
The failure of these treatments just highlights the essential problem in keloids, ie, that no clear molecular mechanism is defined for keloid development. Increased understanding at the molecular level will lead to development of new therapies. Cryotherapy uses liquid nitrogen to cause cell damage and to affect the microvasculature, causing subsequent stasis, thrombosis, and transudation of fluid, which result in cell anoxia. Studies that have evaluated cryotherapy used a protocol of 1-3 freeze cycles lasting from seconds, repeating the therapy every days. The most common adverse effects of treatment are pain and depigmentation.
A keloid is a benign tumour and chronic skin disorder in which excessive scar tissue forms a smooth rubbery growth over the original wound. It is often larger than the wound, and it is mainly made up of collagen. It should be noted that the calculated BED of 30 Gy assumes that the α/β ratio for keloids is 10 (the α/β ratio is a measure of the radiosensitivity of a specific tissue). At present, there is no widely accepted radiation regimen for keloid treatment. Further research on regimens that effectively prevent recurrence without elevating the risk of secondary carcinogenesis is welcome.
Black people, Asians, and Hispanics are more prone to developing keloids. Sometimes, a person may not recall what injury caused a keloid to form.
Treatment consisted of surgical excision, skin grafting, steroid injection, and a silicone sheet pressure dressing. Mechanical compression dressings have long been known to be effective forms of treatment of keloid scars, especially with ear lobe keloids. Compression devices are usually custom-made for the patient and are most effective if worn 24 h/d.
Others have told us keloids have compelled them to keep their arms and legs covered. A keloid is an abnormal proliferation of scar tissue which forms at the site of injury, rises above the skin level,projects beyond original wound margins, and does not regress. While most people never form keloids, others develop them after minor injuries, burns, insect bites and acne spots. Dark skinned people form keloids more easily than Caucasians. Of the many therapies listed, nothing is reliably definitive.
Patients with keloids who agree to contribute to the database answer a short questionnaire about their condition and family history. We also draw a blood sample to examine their DNA and take photos of their scars for observation. If we can identify genetic mutations in patients who keloid, we might one day be able to screen families, correct the mutation, and prevent or dramatically reduce instances of the condition. Patients tend to first notice symptoms between ages 10 and 30, with the 20s as the prime age to develop keloids.