funDERMentals

How to Manage a Keloid

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TAKE-HOME LEARNING POINTS
• The size and shape of keloids obscure the original triggering insult, a fact that serves to distinguish them from normal and hypertrophic scars.

• Keloids never resolve spontaneously, whereas hypertrophic scars can and do.

• Areas most prone to keloid formation include the sternum, deltoids, shoulders, earlobes, and trunk; they are almost unknown on the central face.

• In general, the darker the patient’s skin, the higher the risk for keloid formation.

• Elective surgery (eg, cyst removal) on high-risk areas and in keloid-prone patients should be avoided.

• Keloids can be injected intralesionally with glucocorticoid solutions, such as triamcinolone, or can be excised with proper postop follow-up.

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