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ALL / Dermatology

Keloid scars

Keloid scars

Keloid scars are tumour-like lesions that arise from the connective tissue of a scar and extend beyond the dimensions of the original wound

Predisposing factors
  • ethnicity: more common in people with dark skin
  • occur more commonly in young adults, rare in the elderly
  • common sites (in order of decreasing frequency): sternum, shoulder, neck, face, extensor surface of limbs, trunk

Keloid scars are less likely if incisions are made along relaxed skin tension lines*

Treatment
  • early keloids may be treated with intra-lesional steroids e.g. triamcinolone
  • excision is sometimes required but careful consideration needs to given to the potential to create further keloid scarring


By Htirgan - Own work, CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=32782658">
Image showing a keloid scar at the site of abdominal surgery. Note the lesions below the umbilicus and also in the right iliac fossa. This was possibly a laparoscopic procedure that was

*Langer lines were historically used to determine the optimal incision line. They were based on procedures done on cadavers but have been shown to produce worse cosmetic results than when following skin tension lines
+PassMedicine Notes

Keloid scars are tumour-like lesions that arise from the connective tissue of a scar and extend beyond the dimensions of the original wound

Predisposing factors
  • ethnicity: more common in people with dark skin
  • occur more commonly in young adults, rare in the elderly
  • common sites (in order of decreasing frequency): sternum, shoulder, neck, face, extensor surface of limbs, trunk

Keloid scars are less likely if incisions are made along relaxed skin tension lines*

Treatment
  • early keloids may be treated with intra-lesional steroids e.g. triamcinolone
  • excision is sometimes required but careful consideration needs to given to the potential to create further keloid scarring

*Langer lines were historically used to determine the optimal incision line. They were based on procedures done on cadavers but have been shown to produce worse cosmetic results than when following skin tension lines



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