The natural history and spontaneous resolution of keloid scars 見習醫師:吳易儒醫師 指導醫師:鄭旭棠醫師
Background
● Limited information of natural history and prognosis of keloid scars
● Provide prognostic information to patients● Baseline for future therapeutic trials
Keloid scars
● Many can’t recall injury/infection onset● Invation of surrounding dermis● Aged 10-30 years(appearance concerned)● 5th dermatological dz of black p’t in the UK● High recurrence rates ● Persist for many years● Highly variable/unpredictable growth
pattern● No gold standard therapy
Comparison of Keloid and Hypertrophic scars
Medical Quick Review of Basics http://pgmcqs.com/tag/all-india-mdms-entrance-exams-mcqs/page/7/
Meterials
Manchester Barbados Total
Patients 22 12 34
Keloid scars
83 43 126
Each patient has:-verbal consent-diagnosis of keloid disease-tx or observation at least on of their scars
Demographic and clinical characteristics of keloid patients
● Mean age: 34.5 y/o (range:21-70)Sex: Female(71%)
● Number of scars:6 scars(54%), 5 scars(36%)● Multiple scars:74%● Location:Upper limb(29%), Chest(23%), Ear
(21%)● Mechanism: Acne/chickenpox(32%), Earring
(21%), Vaccination(13%), Trauma(13%)
Results-Defined by patients
Resolution:-satisfactory of appearance/symptoms-recurrence are excludedResolving:-improving with treatment either appearance/symptomsActive scar:-continue to grow/symptoms-not improving with treatment
Conclusion
● Keloid scars can be resolved● Chronicity-Psychosocial consequences● Keloid scars can resolve spontaneously,
early in the disease● Scars didn’t resolve spontaneously may
resolve by treatment many years later
Remained questions
● What causes keloids to spontaneously resolve?
● How they differ from scars that don’t spontaneously resolve?
-Require future star’s further research-Unlock the key to adequately treatment