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Ha B, Kim SJ, Lee YJ, Im S, Park TH. Early outcomes of complete excision followed by immediate postoperative single fractional 10 Gy for anterior chest keloids: A preliminary results. Int Wound J 2022; 20:1418-1425. [PMID: 36324174 PMCID: PMC10088834 DOI: 10.1111/iwj.13996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/09/2022] [Accepted: 10/20/2022] [Indexed: 11/05/2022] Open
Abstract
Treatment of chest keloids is challenging. The aim of this study is to present our experience using surgical excision followed by postoperative single fractional 10 Gy radiotherapy for recurrent anterior chest keloids on the same day. 16 patients with recurrent anterior chest keloids were treated with complete excision followed by single-fractional 10 Gy radiotherapy within eight hours postoperatively. The mean follow-up period was 12 months. (10-14 months) The outcome was reported with a recurrence-free rate. We also reported side effects. The overall recurrence-free rate was 81.25%. The side effects were minimal, with two reported hyperpigmentation which was subsided after six months, and two cases of acute wound problems. Second malignancy or serious complications were not reported. Our preliminary results show positive outcomes of complete excision followed by postoperative single fractional 10 Gy radiotherapy for recurrent anterior chest keloids on the same day. Our current study needs further long-term validation with more diverse patients.
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Affiliation(s)
- Boram Ha
- Department of Radiation Oncology, Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of Korea
| | - Sung Jae Kim
- Department of Orthopedic Surgery, Dongtan Sacred Hospital Hallym University College of Medicine Hwaseong Republic of Korea
| | - Yu Jun Lee
- Department of Plastic and Reconstructive Surgery, Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of Korea
| | - Seongcheol Im
- Department of Plastic and Reconstructive Surgery, Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of Korea
| | - Tae Hwan Park
- Department of Plastic and Reconstructive Surgery, Dongtan Sacred Heart Hospital Hallym University College of Medicine Hwaseong Republic of Korea
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Zhang S, Peng Y, Fan H, Zhang Y, Min P. Microneedle delivery of botulinum toxin type A combined with hyaluronic acid for the synergetic management of multiple sternal keloids with oily skin: A retrospective clinical investigation. J Cosmet Dermatol 2022; 21:5601-5609. [PMID: 35796638 DOI: 10.1111/jocd.15216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/25/2022] [Accepted: 07/04/2022] [Indexed: 12/27/2022]
Abstract
BACKGROUND For the treatment of sternal keloids, corticosteroid therapy has side effects including abnormal sebum secretion and acne. Relapse of keloids is common after corticosteroid injection in patients with oily skin. To reduce side effects and keloid recurrence, we used a combination of botulinum toxin type A (BTX-A) and hyaluronic acid (HA) as synergetic management for multiple sternal keloids in patients with oily skin. METHODS In total, 58 patients with multiple sternal keloids who received monthly steroid injections were retrospectively included. Thirty-two patients in the intervention group received an additional injection of BTX-A/HA on the same day as the first injection of the steroid, while the remaining 26 patients were treated as the control group. At baseline and follow-up visits, sebum production and transepidermal water loss (TEWL) were assessed as primary outcomes, and the Vancouver Scar Scale (VSS) score, keloid recurrence, visual analog scale (VAS) score, and patient satisfaction were assessed as secondary outcomes. RESULTS In the control group, average sebum production and TEWL were increased to 132% and 104% of baseline, respectively, at the 24-week follow-up. In the intervention group, average sebum production and TEWL reached nadir at the 8-week follow-up and then increased to 96% and 91% of baseline, respectively, at the 24-week follow-up. Sternal keloid relapse was observed in 88.5% of the patients in the control group and none of the patients in the intervention group. The total VSS score at 24 weeks was 11.04 ± 0.14 and 8.93 ± 0.26 (p < 0.001) in the control group and intervention group, respectively, and the VAS score was 75 ± 5.10 and 19.14 ± 3.80 (p < 0.001) in the control group and intervention group, respectively. Higher patient satisfaction was reported in the intervention group. CONCLUSIONS Microneedle delivery of BTX-A/HA decreases sebum production while improving skin barrier function. Thus, this combined therapy can relieve the side effects of corticosteroid therapy and reduce keloid recurrence.
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Affiliation(s)
- Shunuo Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Peng
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Fan
- Burns and Plastic Surgery Department and Plastic Surgery Cosmetology Laser Center, General Hospital of Jilin Chemical Industry Group (The Second Affiliated Hospital of Beihua University), Jilin, China
| | - Yixin Zhang
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Peiru Min
- Department of Plastic and Reconstructive Surgery, Shanghai Ninth People's Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Liu H, Sui F, Liu S, Song K, Hao Y, Wang Y. Large chest keloids treatment with expanded parasternal intercostal perforator flap. BMC Surg 2021; 21:147. [PMID: 33743633 PMCID: PMC7981883 DOI: 10.1186/s12893-021-01116-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 02/23/2021] [Indexed: 11/29/2022] Open
Abstract
Background Chest keloids often converged into a large lesion on the chest in some patients. Such keloids often lead to obstacle to excision and reconstruction. We describe a surgical method for large chest keloids with expanded parasternal intercostal perforator flap (EPIPF). Methods Fifteen patients with chest keloid were treated with EPIPF in our department between August 2017 and Dec 2019. The surgical treatment was divided into two different phases. In the first phase, we implanted skin expanders into the layer under the deep fascia beside the keloids. The expander was expanded every week for about 3–4 months. In the second phase, the expander was removed, the keloid tissue was removed and an expanded perforator flap was then designed to cover the wound. Patients were followed-up after surgery. Complications after surgery were analyzed. Recurrence and the patients, satisfactory rate was recorded. Results Of the 15 patients, one patient complicated with undesirable small area wound healing. 11 were cured without scar hypertrophy or recurrence and four were partially cured with a small portion of scar hypertrophy. Eleven patients thought that the esthetic result was good (73.7%), and 4 patients thought the result was acceptable (26.7%). None patient was dissatisfied. Conclusion EPIPF are effective surgical method for managing large chest keloids. It can offer enough skin flap coverage for keloid wound resurfacing with stable blood supply to assure satisfactory results. Level of evidence Level IV, case series.
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Affiliation(s)
- Hao Liu
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.,Chiese Academy of Medical Sciences, Peking Union Medical College, Beijing, China
| | - Fuqiang Sui
- Department of Burn and Plastic Surgery, 969 Hospital Associated With Logistic Support Forces of the Chinese People's Liberation Army, Neimenggu, China
| | - Shu Liu
- Department of General Surgery, Civil Aviation General Hospital, Beijing, China
| | - Kexin Song
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Yan Hao
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China
| | - Youbin Wang
- Department of Plastic Surgery, Peking Union Medical College Hospital, Beijing, China.
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Song K, Wang Y, Zhang M, Wang X. A parasternal intercostal perforator flap for esthetic reconstruction after complete chest keloid resection: A retrospective observational cohort study. J Cosmet Dermatol 2018; 17:1205-1208. [PMID: 30393934 DOI: 10.1111/jocd.12782] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 08/15/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Ke‐Xin Song
- Department of Plastic and Aesthetic Surgery Peking Union Medical College Hospital, CAMS and PUMC Beijing China
| | - You‐Bin Wang
- Department of Plastic and Aesthetic Surgery Peking Union Medical College Hospital, CAMS and PUMC Beijing China
| | - Ming‐Zi Zhang
- Department of Plastic and Aesthetic Surgery Peking Union Medical College Hospital, CAMS and PUMC Beijing China
| | - Xiao‐Jun Wang
- Department of Plastic and Aesthetic Surgery Peking Union Medical College Hospital, CAMS and PUMC Beijing China
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Park TH, Lee JW, Kim CW. The fortune cookie flap for aesthetic reconstruction after chest keloid resection: a small case series. J Cardiothorac Surg 2018; 13:31. [PMID: 29673376 PMCID: PMC5907744 DOI: 10.1186/s13019-018-0713-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 04/04/2018] [Indexed: 11/23/2022] Open
Abstract
Background Generally, the recurrence rate of keloids is unacceptably high after surgical excision alone. Nevertheless, surgical reduction of keloids is inevitable in many cases. The reconstruction of extensive soft tissue defects following complete keloid resection is challenging to surgeons. In this study, we present our clinical experience using a novel fortune cookie flap for treating chest keloids. This flap provides an excellent surgical option that maintains natural appearance with minimal donor-site morbidity. Methods We retrospectively reviewed the data from 3 consecutive cases of reconstruction using the fortune cookie flap following resection of chest keloids between March and December, 2017. Results Successful reconstructions were performed without any major complications. The mean dimensions of the reconstructed defect were 5.0 × 4.2 cm, while the mean dimensions of the flap were 7.7 × 5.7 cm. Conclusions Owing to its simplicity, reliability, versatility, minimal morbidity and excellent aesthetics, the fortune cookie flap is as an excellent option for reconstruction following complete keloid resection on the chest. Electronic supplementary material The online version of this article (10.1186/s13019-018-0713-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tae Hwan Park
- Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi, 13496, Republic of Korea.
| | - Jang Won Lee
- Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi, 13496, Republic of Korea
| | - Chan Woo Kim
- Department of Plastic and Reconstructive Surgery, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam, Gyeonggi, 13496, Republic of Korea
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WULANDARI ENDAH, JUSMAN SRIWIDIAA, MOENADJAT YEFTA, JUSUF AHMADA, SADIKIN MOHAMAD. Expressions of Collagen I and III in Hypoxic Keloid Tissue. THE KOBE JOURNAL OF MEDICAL SCIENCES 2016; 62:E58-E69. [PMID: 27604536 PMCID: PMC5425142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 06/08/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Wound heals itself spontaneously as physiological process. However, in some individuals, small wounds such as parenteral injections or body piercings may cause increased expression of collagen synthesis. The condition is known as keloid. Histopathology of keloid demonstrates extensive tissue proliferation that extends beyond the margin of primary wound. As a result, it develops uncontrolled or excessive fibrogenesis and tremendous source of collagen that still causes clinical problems until now. A wound, no matter how small the size is, will be followed by increased expression of collagen synthesis. Procollagen I and III is one of markers indicating the development of fibrosis. In fibrosis, there is hypoxia, which is characterized by stabilization of HIF-1α. Therefore, our study was aimed to obtain information about expression of collagen I and III in hypoxic keloid tissue. METHOD The study design was observational descriptive. Keloid specimens were obtained from biopsy and preputium skins as the control specimens were obtained from circumcision. There were 10 tissue specimens for each specimen group. The analysis performed were evaluation of mRNA expression on collagen I, collagen III and HIF-1α using RT-PCR, the evaluation of HIF-1α protein level using ELISA and the expression of collagen I and collagen III protein using immunohistochemistry. Statistically, data was analyzed by unpaired t-test. RESULTS In keloid with excessive cell proliferation, we found that the expression of procollagen I mRNA increased 35 times and the expression of procollagen III mRNA increased 27.1 times compared to preputium control group (p<0.05). The expression of procollagen I protein in the dermal layer of keloid was 61% and in the preputium was 37% (p<0.05). The expression of collagen III protein in the dermal layer of keloid was 39% and in the preputium was 16% (p<0.05). There was a 5-fold increase on expression of HIF-1α mRNA in keloid tissue compared to those in preputium (p<0.05). The levels of HIF-1α protein in keloid tissue was 0.201 ng/mg protein and the level in preputium was 0.122 ng/mg protein (p<0.05). There was a strong positive and extremely significant correlation between the expression of HIF-1α protein and procollagen III (R=0.744; p<0.05, Pearson), but HIF-1α with procollagen I are weak correlation (R=0.360; p>0.05, Pearson) Conclusion: Expression of collagen I and III have important role in hypoxic keloid tissue characterized by increased expressions. The expression of collagen I and III is associated with stable HIF-1α in keloid tissue.
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Affiliation(s)
- ENDAH WULANDARI
- A student of Biomedical Doctoral Program at Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Biochemistry, Faculty of Medicine and Health Sciences of State Islamic University Syarif Hidyatullah, Jakarta, Indonesia
| | - SRI WIDIA A JUSMAN
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - YEFTA MOENADJAT
- Department of Surgery, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - AHMAD A JUSUF
- Department of Histology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - MOHAMAD SADIKIN
- Department of Biochemistry and Molecular Biology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
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Xue D, Qian H. Surgical management for large chest keloids with internal mammary artery perforator flap. An Bras Dermatol 2016; 91:103-5. [PMID: 26982790 PMCID: PMC4782658 DOI: 10.1590/abd1806-4841.20163977] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2014] [Accepted: 10/07/2014] [Indexed: 12/02/2022] Open
Abstract
Therapy for large symptomatic keloids is often plagued with complicated
reconstruction manner and recurrence. This article reports a rare treatment
combination for a chest keloid with internal mammary artery perforator flap
reconstruction and radiation therapy. We excised the keloid and covered the
defect with an internal mammary artery perforator flap. Immediate electron-beam
irradiation therapy was applied on the second postoperative day. There was no
sign of recurrence over the follow-up period of 18 months. The combination of
internal mammary artery perforator flap and immediate radiation therapy is
useful when faced with chest keloids of similar magnitude and
intractability.
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Affiliation(s)
- Dan Xue
- Zhejiang University, Hangzhou, Zhejiang, China
| | - Huan Qian
- Zhejiang University, Hangzhou, Zhejiang, China
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Clinical implications of single- versus multiple-site keloid disorder: a retrospective study in an Asian population. Ann Plast Surg 2015; 74:248-51. [PMID: 24681623 DOI: 10.1097/sap.0b013e3182a2b537] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND There is strong evidence of genetic susceptibility in individuals with keloid disorder. The purpose of this cross-sectional study was to determine the clinical relevance of our proposed variables on the multiplicity of keloids by further investigating the presence of other keloids and a family history. METHODS This was a retrospective review, using institutional review board-approved questionnaires, of patients with keloids who were seen at Kangbuk Samsung Hospital between December 2002 and February 2010. Eight hundred sixty-eight patients were included in our study. Comparisons between the 2 groups were made using Mann-Whitney tests for continuous variables and χ2 tests for categorical variables. RESULTS In our patient group, younger age of onset and the presence of family history were significantly associated with the occurrence of keloids at multiple sites. The locations of extra-auricular keloids, in order of frequency, included the shoulder; anterior chest, including the breasts; deltoid; trunk and pubic area; upper extremities; lower extremities; and other sites. As compared to secondary keloids, primary keloids were significantly associated with both a lower degree of recurrence and the presence of other keloids. The presence or absence of family history was significantly associated with the presence or absence of other keloids and primary or secondary keloids. CONCLUSIONS Keloid disorder is one of the most frustrating problems in wound healing and advances in our understanding of the differences of occurrence at a single site versus multiple sites might help in understanding pathogenesis and improving treatment.
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Location of Keloids and Its Treatment Modality May Influence the Keloid Recurrence in Children. J Craniofac Surg 2015; 26:1355-7. [DOI: 10.1097/scs.0000000000001747] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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10
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Abstract
Every element or cell in the human body produces substances that communicate and respond in an autocrine or paracrine mode, consequently affecting organs and structures that are seemingly far from each other. The same also applies to the skin. In fact, when the integrity of the skin has been altered, or when its healing process is disturbed, it becomes a source of symptoms that are not merely cutaneous. The skin is an organ, and similar to any other structure, it has different functions in addition to connections with the central and peripheral nervous system. This article examines pathological responses produced by scars, analyzing definitions and differences. At the same time, it considers the subcutaneous fascias, as this connective structure is altered when there is a discontinuous cutaneous surface. The consequence is an ample symptomatology, which is not limited to the body area where the scar is located, such as a postural or trigeminal disorder.
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Affiliation(s)
- Bruno Bordoni
- Rehabilitation Cardiology Institute of Hospitalization and Care with Scientific Address, S Maria Nascente Don Carlo Gnocchi Foundation. CRESO Osteopathic Centre for Research and Studies
| | - Emiliano Zanier
- EdiAcademy, Milano, Italy. CRESO Osteopathic Centre for Research and Studies
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Park TH, Park JH, Chang CH. Clinical features and outcomes of foot keloids treated using complete surgical excision and full thickness skin grafting followed by corticosteroid injections. J Foot Ankle Res 2013; 6:26. [PMID: 23856363 PMCID: PMC3717136 DOI: 10.1186/1757-1146-6-26] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/11/2013] [Indexed: 11/25/2022] Open
Abstract
Background Keloids are often resistant to treatment and have high recurrence rates. To the best of the authors’ knowledge, however, there have been very few case reports related to foot keloids. The purpose of this retrospective case-series was to summarize the baseline characteristics of a cohort of patients, introduce our treatment regimen for the successful treatment of foot keloids. Methods Patients were treated with surgical excision followed by full thickness skin grafting combined with postoperative steroid injections combined with silicone gel sheeting over a period of eight years from December 2004 to November 2012 at our institution. Subjective outcome was evaluated using Patient Scar Assessment Scales. The final objective outcome was judged by two independent physicians at the time of 12 months after treatment as recurrence or non-recurrence. Results Of 79 patients, 75 (94.9%) were women and 4 (5.1%) were men. The average age was 18 (range 7-43) years. The average pretreatment total size of the lesions was 50 (range 18-150) cm. The number of patients treated for a primary foot keloid was 29 (36.7%), and 70 patients (63.3%) were treated for a recurrent keloid that failed to respond to prior treatments. Prior treatments included single therapies such as surgical excision alone (4 patients, 5.1%), prior steroid injection alone (33 patients, 41.8%), and laser therapy (2 patients, 2.5%). Other therapies included combination treatments (11 patients, 13.9%). Most patients reported improved Patient Scar Assessment Scale by lapse of time. All patients completed the treatment regimen and follow-up of 12 months. Of these patients, 62 patients (78.5%) achieved successful treatment, while the remaining 17 (21.5%) experienced recurrence. Conclusions We successfully treated foot keloids using complete surgical excision and full thickness skin grafting followed by four corticosteroid injections (at one month intervals).
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Affiliation(s)
- Tae Hwan Park
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Deokjeok Health Care Center, Incheon, Republic of Korea
| | - Ji Hae Park
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Choong Hyun Chang
- Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Abstract
Keloid disorder (KD) is a fibroproliferative ailment of the cutaneous connective tissue secondary to dysregulation in various skin repair and healing processes. This disorder is characterized by excess collagen and/or glycoprotein depositions in the dermis. Age of onset of KD is not well documented. Based on clinical observations, various authors have reported the onset of KD to be between the ages of 10 and 30 years. We report on an African American female who developed bilateral auricular keloids at the age of 9 months. To our knowledge, this is the youngest age at which a patient has been documented to have developed KD.
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Keloid recurrence in pregnancy. Aesthetic Plast Surg 2012; 36:1271-2. [PMID: 22890860 DOI: 10.1007/s00266-012-9947-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Accepted: 06/09/2012] [Indexed: 10/28/2022]
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Letter regarding “Treatment outcomes for keloid scar management in the pediatric burn population”. Burns 2012; 38:944-5; author reply 945-6. [DOI: 10.1016/j.burns.2012.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2012] [Accepted: 03/26/2012] [Indexed: 11/22/2022]
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Abstract
Complications in surgery are an unfavorable outcome as a result of a procedure. These can occur intraoperatively, immediately after or in the distant future. Minimizing the risk and prompt treatment of complications is important to avoid potentially disastrous outcomes. This article will review the more common complications of cutaneous surgery and then analyze the legal consequences of these complications.
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Affiliation(s)
- Jeremy Man
- Skin Laser and Surgery Specialists of New York and New Jersey, USA
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16
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Clinical characteristics of facial keloids treated with surgical excision followed by intra- and postoperative intralesional steroid injections. Aesthetic Plast Surg 2012; 36:169-73. [PMID: 21735339 DOI: 10.1007/s00266-011-9781-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Accepted: 06/13/2011] [Indexed: 10/18/2022]
Abstract
BACKGROUND The physiopathogenesis of keloid scars is not well understood. This report aims to present the authors' experiences with facial keloids, to evaluate their treatment outcomes via a prospective study, and to identify risk factors involved in facial keloid recurrence. METHODS Patients with facial keloids were treated with surgical excision followed by intra- and postoperative intralesional steroid injections at Kangbuk Samsung Hospital between July 2005 and June 2010. Of 15 keloids, 8 (53.3%) had previously been treated unsuccessfully at other hospitals. The follow-up period was 18 months, and therapeutic outcomes were evaluated based on recurrence or nonrecurrence. RESULTS The study evaluated 17 facial keloids in 15 patients. The overall recurrence-free rate was 76.5% after a follow-up period of 18 months. The authors hypothesized that the recurrence of keloids on the face is associated with both previous treatment and anatomic location. CONCLUSIONS The authors' protocol resulted in successful outcomes for the treatment of facial keloids. Patients with a history of previous treatment and keloids in the perioral region should be monitored closely for signs of recurrence and managed cautiously during treatment.
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