Regression of massive keloid following partial excision and post-operative intralesional administration of triamcinolone

doi:10.1016/S0007-1226(67)80076-6

British Journal of Plastic Surgery

Volume 20, 1967, Pages 432-435

https://doi.org/10.1016/S0007-1226(67)80076-6 Get rights and content

Summary

A massive auricular keloid which had rapidly recurred after three previous excisions and a course of radiation therapy was treated effectively by partial excision and intralesional steroid administration. Complete excision would have resulted in considerable deformity in this case because the lesion already encroached significantly on adjacent auricular structures. Almost complete regression of the keloid occurred gradually during steroid therapy, and regrowth of the lesion has not been seen since medication was discontinued one year ago. No systemic or local complications occurred.

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Fibroproliferative scars
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Hypopigmentation along subcutaneous veins following intrakeloid triamcinolone injection: A case report and review of literature
1998, Burns
Keloids and hypertrophic scars
1994, Clinics in Dermatology
Keloids and hypertrophic scars occur in predisposed individuals following trauma, inflammation, surgery, or burns and occasionally they occur spontaneously. These fibrous growths are abundant depositions of collagen and glycoprotein. Early reports often included both keloids and hypertrophic scars from various anatomic sites. Such reports add confusion to a poorly understood wound response. Later reports distinguish keloids from hypertrophic scars in terms of extension beyond the original wound and clinical course. Hypertrophie scars typically remain within the confines of the original wounds and these raised scars often spontaneously regress. Hypertrophic scars occur soon after the antecedent trauma or inflammation. In general, the hypertrophic scar remains within the limit of the wound or inflammation and the lesion may increase in size or regress over months to years. Keloids occur in predisposed individuals and the enlarging lesions extend beyond the original wound and rarely regress.¹ Individuals with severely disfiguring multiple keloids are more likely to have a family history of keloids, suggesting a genetic predisposition for this abnormal wound response. The cause of this abnormal wound response is unknown, but abnormal cellular responses may account for the abundant connective tissue deposition. These fibrous growths typically generate significant disfigurement and unwanted symptoms, such as pruritus or pain. Multiple treatment approaches have been reported and responses are highly variable. Therapy selection should be carefully matched to the individual and the abnormal wound response to obtain the best possible result.
Scars and keloids
1993, Dermatologic Clinics
Scars and keloids are fibrous growths that generally occur after trauma or inflammation in predisposed individuals. These abnormal wound responses are characterized by abundant deposition of collagen and glycoprotein. Recent studies suggest an abnormal cellular response in fibroblast cultures of keloids to account for these abnormal wounds. Treatment responses vary, and therapy should be carefully selected for each lesion.
Keloid formation in a simple syndactyly release: A case report
1992, Journal of Hand Surgery
Single-dose electron beam irradiation in treatment and prevention of keloids and hypertrophic scars
1990, Radiotherapy and Oncology
Low megavolt electron beam irradiation was used on 354 sites in 199 patients at the Lahey Clinic either for palliation of symptomatic hypertrophic scars or as post-operative irradiation in an attempt to prevent formation or recurrence of hypertrophic scars. Electron energies used ranged from 1.5 to 3.5 MeV. The median age of the 59 male patients was 22 years and of the 140 female patients, 35 years. All patients had at least one follow-up visit, and the median follow-up was 35 months. Of the 294 sites treated for the first time, 272 (93%) were irradiated with a single fraction with a skin dose ranging from 2 to 20 Gy. Of the 85 sites in 63 patients without excision of symptomatic hypertrophic scars, single-dose electron beam irradiation was of clinically significant value in only 41 sites (48%). No patients have been treated without surgical excision since 1973. Because of a history of formation of hypertrophic scars elsewhere in the body, 13 patients with 19 incisions were treated prophylactically after operation for other diseases. All sites were irradiated with single doses ranging from 8 to 20 Gy, and hypertrophic scars did not subsequently develop in any patient. Altogether, 119 patients with 174 sites were irradiated after surgical excision of hypertrophic scars to prevent recurrence; 168 sites (97%) received single-fraction irradiation, and 161 received a dose of 8 Gy or greater, up to 15 Gy. No statistically significant differences were observed in complete success rates, ranging from 82 to 90% with doses of 9 Gy or greater. An interval of up to 72 h between excision and single-fraction irradiation satisfactorily prevented recurrence, and clinically significant chronic telangiectasia was recorded in only one patient. Postoperative low megavolt electron beam irradiation with a single dose of 9 Gy or greater is highly effective in the prevention of formation or recurrence of hypertrophic scars or keloids.

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Original articleRegression of massive keloid following partial excision and post-operative intralesional administration of triamcinolone

Summary

Archs Derm. Syph.

Plastic reconstr. Surg.

Plastic reconstr. Surg.

Original article
Regression of massive keloid following partial excision and post-operative intralesional administration of triamcinolone