Why more keloids on back than on front of earlobe

Does ear keloid formation depend on the type of earrings or piercing jewellery?

The ear is one of the most common sites of keloid formation, usually associated with the wearing of earrings. However, although this is a small perforating lesion that is equal on both sides, keloids are bigger and more prevalent on the posterior surface. In this study, 141 keloids were evaluated, most of which were located on the posterior surface of the earlobe and caused by the piercing of the ear. Most of the earrings and piercing jewellery used had metallic backs. The more frequent occurrence of earlobe keloids on the posterior surface of the ear therefore may be associated with the exacerbation of local neurogenic inflammation caused by the metallic backs.

Earlobe reconstruction using a subcutaneous island pedicle flap after resection of "earlobe keloid"

BACKGROUND

A large keloid of the earlobe is a difficult case in which to obtain a satisfying result by nonsurgical therapies. In this case, surgical resection of keloids should be considered as a first step in therapy. However, it is difficult to reconstruct the earlobe cosmetically after resection of the lesion.

OBJECTIVE

To discuss the usefulness of the subcutaneous island pedicle flap in earlobe keloid surgery.

METHODS

Five earlobe keloids in five patients (four females and one male) were resected and reconstructed by subcutaneous island pedicle flap.

RESULTS

In all patients, there were no keloid recurrences and no adjuvant therapies used during the follow-up periods, which ranged from 10 to 26 months. The reconstructed earlobes were almost symmetrical.

CONCLUSION

In the selected cases, use of the subcutaneous island pedicle flap is a viable method to be considered for reconstruction after resection of earlobe keloids.