BACKGROUND: Keloids are benign fibrous growths that are caused by excessive tissue build-up. Severe keloids exert more significant effects on patients' quality of life than do mild keloids. We aimed to identify factors associated with the progression from mild keloids to severe keloids, as distinct from those associated with the formation of keloids. METHODS: In this retrospective case-control study, 251 patients diagnosed with keloids at West China Hospital between November 2018 and April 2021 were grouped according to the severity of lesions (mild [n = 162] or severe [n = 89]). We collected their basic characteristics, living habits, incomes, comorbidities, and keloid characteristics from Electronic Medical Records in the hospital and the patients' interviews. Conditional multivariable regression was performed to identify the independent risk factors for the progression of keloids. RESULTS: Eighty-nine patients (35.5%) were classified as having severe keloids. We found the distribution of severe keloids varied with sex, age, excessive scrubbing of keloids, family income, the comorbidity of rheumatism, disease duration, characteristics of the location, location in sites of high-stretch tension, the severity and frequency of pain, the severity of pruritus, and infection. Multivariable analysis revealed significant associations between severe keloids and infection (odds ratio [OR], 3.55; P = 0.005), excessive scrubbing of keloids (OR, 8.65; P = 0.001), low or middle family income (OR, 13.44; P = 0.021), comorbidity of rheumatism (OR, 18.97; P = 0.021), multiple keloids located at multiple sites (OR, 3.18; P = 0.033), and disease duration > 15 years (OR, 2.98; P = 0.046). CONCLUSION Doctors should implement more active and thorough measures to minimize the progression of mild keloids in patients who have any of the following risk factors: infection, excessive scrubbing of keloids, low or middle family income, comorbidity of rheumatism, multiple keloids located at multiple sites, and disease duration > 15 years.
Case-Control Studies ; Humans ; Keloid/epidemiology* ; Quality of Life ; Retrospective Studies ; Rheumatic Diseases ; Risk Factors

BACKGROUND: Keloid management can be difficult and frustrating, and the mechanisms underlying keloid formation are only partially understood. Despite many studies of the pathogenesis and cause, little is known of the predisposing factors or the diathesis. Therefore, we evaluated patients with keloid for 13 years clinical experience, with the goal of considering the causative factors and physical disposition of keloid. METHODS: We evaluated 107 patients (38 males, 69 females; median age 22.31 years, range 7-58 years) who visited the department of plastic and reconstructive surgery from March 1998 to December 2010. The patients' chart and clinical photo were reviewed for the study. RESULTS: Etiologies were an intended wound like piercing or surgical wound (n=39), avulsion flap injury (n=30), laceration (n=29) and burn (n=9). The location were the head and neck (n=38), trunk (n=23), upper extremity (n=21), lower extremity (n=16) and face (n=9). Patients with more than overweight (>23 kg/m2, Body mass index) were 84 in 107 patients (78.5%) with keloids. CONCLUSIONS: In the care of the keloids, patient information, particularly sex, age and body mass index, it may be useful indicators for expecting prognosis of the patients and treating with proper management. Particularly, large-scale accurate follow-up observations on obese patients will be critical.
Body Mass Index ; Burns ; Causality ; Disease Susceptibility ; Epidemiology ; Female ; Head ; Humans ; Keloid* ; Lacerations ; Lower Extremity ; Male ; Neck ; Overweight ; Prognosis ; Upper Extremity ; Wounds and Injuries

OBJECTIVETo investigate the relationship between p53 codon 72 polymorphism and susceptibility to keloid in a southern Chinese population.

METHODSThe p53 genotypes were determined by polymerase chain reaction-reverse dot blot (PCR-RDB) and DNA direct sequencing in 45 patients with keloid and 60 unrelated healthy controls.

RESULTSThe frequency of the p53 Pro allele among keloid patients was significantly higher than that among healthy controls (chi2 = 4.485, P = 0.034). The Pro/Arg and Arg/Arg genotype distribution among keloid patients was not significantly different from that among healthy controls (chi2 = 0.949, 1.346; P = 0.330, 0.246, respectively). However, the Pro/Pro genotype frequency among keloid patients was significantly higher than that among healthy controls (chi2 = 4.375, P = 0.036). The p53 Pro/Pro genotype significantly increased the risk for developing keloid, compared to the combination of Pro/Arg and Arg/Arg genotypes,with the odds ratio (OR) of 2.400 (95%CI: 1.048-5.498).

CONCLUSIONSDetermination of the p53 codon 72 genotype may be used as a stratification marker to predicate high-risk individuals for keloid.

Adolescent ; Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; Base Sequence ; Child ; China ; epidemiology ; Codon ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Keloid ; epidemiology ; genetics ; Male ; Middle Aged ; Polymorphism, Genetic ; Tumor Suppressor Protein p53 ; genetics ; Young Adult