Diagnosis: Keloid
Scope and content: Rayburns. Formation of keloids. Copper-red tissue at center. Dark red-brown hyper-pigmented zone at margins. Close-up. Hiroshima.. Clinical photograph sourced from Wikimedia Commons (Public domain). Attribution: Unknown authorUnknown author or not provided.
Firm, smooth, rubbery, shiny, raised scars extending beyond the wound border. Often pruritic or painful. Predilection sites: earlobes, chest, shoulders, upper back. Color ranges from flesh-colored to red to dark brown. May continue to grow over years.
Often follows trauma, surgery, piercings, burns, acne, or vaccination. More common in ages 10-30 and in patients of African, Asian, and Hispanic descent. Family history is common (autosomal dominant with variable penetrance).
Intralesional triamcinolone (first-line, 10-40 mg/mL). Combination: excision + immediate post-op radiation or triamcinolone. Silicone sheets/gel. Cryotherapy. Pressure earrings post ear keloid excision. 5-FU intralesional injections.
Hypertrophic scar, Dermatofibrosarcoma protuberans, Dermatofibroma, Morphea
Keloids extend BEYOND original wound borders (distinguishes from hypertrophic scars). Surgical excision alone has 50-100% recurrence rate — always combine with adjuvant therapy. Prevention in high-risk patients: pressure garments, silicone sheeting, avoid elective procedures.
Tags: keloid, scar, fibroproliferative, wound healing