Piercing Ear Keloid: Excision Using Loupe Magnification and Topical Liquid Silicone Gel as Adjuvant

Compression Therapy for Keloid Scars: A Systematic Review and Meta-analysis

Background

Keloid scars have a multitude of treatments with varying success rates. The purpose of this systematic review and meta-analysis is to study the different types of compression therapies used following surgical excision and their recurrence rates.

Methods

A literature search was conducted using the following databases: PubMed, Embase, and Cochrane Reviews. The following keywords were used in the search: "keloid" and "compression." The following inclusion criteria were used: (1) identifying lesion must be a keloid and (2) use of any type of compression therapy for keloid scar.

Results

A total of 27 articles were included in the final analysis, grouped into three treatment modalities for comparison. The three treatment modalities are (1) surgical excision and compression earring, (2) surgical excision and silicone gel sheeting, and (3) surgical excision, compression earring, and silicone gel sheeting. Based on our analysis, combination treatment with compression earring device and silicone gel sheeting had the lowest recurrence rate when compared with compression earring device or silicone gel alone, but the difference in recurrence rates between the three treatment modalities was not statistically significant.

Conclusions

There were too few studies included in each treatment modality with even fewer sample sizes, and there is a need for a greater number of studies with increased sample size to evaluate which therapy is the most efficacious in preventing keloid recurrence following surgical excision.

Ear Keloids Treated with Postoperative Electrons: A Case Series

Introduction Multiple modalities exist for treating keloids ranging from surgical, medical, chemotherapeutic, and radiation therapy. Different techniques of radiation therapy have been used to treat keloids as an adjuvant to surgical excision. With this case series, we report our experience of using electron beam radiation therapy in this setting.

Materials and Methods We retrospectively analyzed 16 ear keloids treated in 10 patients from January 2013 to October 2015 with surgical excision followed by electron beam to a dose of 10 Gy in two fractions over two consecutive days in immediate postoperative period. Patients were evaluated for recurrent lesions, cosmesis, and adverse effects.

Results With a median follow-up of 78 months (range: 67–100 months), recurrent lesion was seen in five cases; a local control rate of 68.75% was seen. Median recurrence-free period was 67 months (range: 12–100 months). Acceptable cosmesis was seen in all cases and no acute or chronic adverse effects were seen.

Conclusion The large follow-up period in our series establishes the role of electron beam radiation therapy in attaining long-term control in keloid patients. The lower total dose with higher dose per fraction used in our patients has acceptable control along with good cosmesis and absent adverse effects.

Optimizing Surgical Procedures of Auricular Keloids According to Their Anatomic Morphological Features

BACKGROUND

Aesthetic surgical reconstruction of auricular keloids is still a conundrum. This study introduces our experiences in analyzing the anatomic morphological features of auricular keloids, and devising optimized surgical procedures accordingly.

METHODS

A total of 129 ears with auricular keloids were classified and operated. All patients were followed up for at least 12 months.

RESULTS

According to their anatomic positions, auricular keloids were divided into 3 Groups (A, B, and C). The morphological features of keloids were further interpreted according to Chang-Park classification of earlobe keloids. The authors optimized surgical procedures according to the anatomic morphological features from a range of surgical techniques. The recurrence rate of Group C was statistically higher than Group A and B. There was no significant difference in recurrence rate between keloids treated with "primary suture" and "filleted flaps."

CONCLUSIONS

According to the anatomic positions and morphological features of auricular keloids, we could conveniently devise optimized surgical strategies to obtain aesthetic reconstruction of auricular keloids.