Keloids

Abstract

Keloids are scar tissues that usually occur at the site of previous injuries and traumas, though they sometimes arise spontaneously (Fig. 5.1). In comparison to hypertrophic scars, keloids go beyond the margins of the original injury. They can be pruritic and painful, and they can be disfiguring or cause discomfort, depending on their locations. The presentations shown in this chapter are those that are unique to or more commonly described in patients with black skin.

Keloids are scar tissues that usually occur at the site of previous injuries and traumas, though they sometimes arise spontaneously (Fig. 5.1). In comparison to hypertrophic scars, keloids go beyond the margins of the original injury. They can be pruritic and painful, and they can be disfiguring or cause discomfort, depending on their locations. The presentations shown in this chapter are those that are unique to or more commonly described in patients with black skin.

They are seen in all races, but they are most common in blacks and Asians. In other races, they are more site-specific and can be seen more often on the chest and neck. In blacks, they can occur anywhere on the body.

Since keloids are so common in black patients we present them separately in this chapter.

5.1 Presentation in Black Skin

Keloids in black skin are more common and tend to be larger (Figs. 5.2–5.19). In addition to the chest and neck, ears are a very common location for keloids to form. They are skin-colored in black patients, whereas in white patients they are generally red (Figs. 5.20 and 5.21).

5.2 Treatments

The many treatment options include Interlesional injections, surgery, radiation, and laser.

Fig. 5.1

Spontaneous keloids without cause

Fig. 5.2

Keloid secondary to removal of an epidermoid cyst

Fig. 5.3

Ear keloid secondary to piercing

Fig. 5.4

Keloid on the arm secondary to tattoo removal by surgery

Fig. 5.5

Keloid on the ear secondary to multiple piercings

Fig. 5.6

Keloid on the ear secondary to ear piercing

Fig. 5.7

Keloid secondary to removal of an inter dermal nervous

Fig. 5.8

Thermal burn

Fig. 5.9

Keloid due to breast reduction

Fig. 5.10

Keloid secondary to surgery for removal of keloid

Fig. 5.11

Keloid secondary to ear piercing

Fig. 5.12

Keloid secondary to acne

Fig. 5.13

Keloid secondary to injury to scalp

Fig. 5.14

Keloid after knee surgery

Fig. 5.15

Keloid after abdominal surgery

Fig. 5.16

Keloid after acne lesion of the breast

Fig. 5.17

Keloid after surgical removal of epidermoid cyst

Fig. 5.18

Keloid after hair transplant

Fig. 5.19

Keloid after ear piercing at multiple sites

Fig. 5.20

Keloid in white patient after thyroid surgery

Fig. 5.21

Hypertrophic scar in white patient after surgery