OBJECTIVETo explore the clinical classification method of keloids and providing a thread for the treatment of keloids.

METHODSTo summarize the 600 cases of keloid patients we accepted and diagnosed from November 2004 to October 2012, and filling in keloid patients information sheet, recording the keloids form by photographs, analyzing the treatment, putting forward the classification method of keloids in clinic.

RESULTSAccording to the position and quantity that keloids grow, the keloid patients are divided into four major categories:one in single site, one in each site, more than one in single site and more than one in each site; According to the area and thickness of keloids, the keloid single lesion is divided into four subclasses: type of small area and thin, type of small area and thick, type of large areas and thin,type of large areas and thick; According to the number of lesions, keloid multiple lesions is divided into two subgenera: isolated multiple and dispersion multiple, different kinds of keloids suit different methods of treatment.

CONCLUSIONThe clinical classification method of keloids can be used to provide thought for the treatment of keloids, and have a good application value.

Humans ; Keloid ; classification ; pathology ; therapy

Burns ; complications ; therapy ; Cicatrix, Hypertrophic ; therapy ; Humans ; Keloid ; therapy

Keloids are benign fibrcus growths which extend beyond the original wound and rarely regress. Available methods of treatment include surgical excision, radiotherapy, intralesional steroid injection, cryotherapy, systemie. chemotherapy, zinc tape strapping, pressure, silicon gel and combined therapy. Postoperative irradiation is a useful and effective method of eradication or prevent.ion of keloid. We describe two cases of the prevention of keloids associated with postoperative irradiation.
Cryotherapy ; Drug Therapy ; Keloid* ; Radiotherapy ; Silicone Gels ; Wounds and Injuries ; Zinc

BACKGROUND: Hyperbaric oxygen treatment (HBOT) has been demonstrated to influence the keloid recurrence rate after surgery and to relieve keloid symptoms and other pathological processes in keloids. To explore the mechanism of the effect of HBOT on keloids, tumor immune gene expression and immune cell infiltration were studied in this work. METHODS: From February 2021 to April 2021, HBOT was carried out on keloid patients four times before surgery. Keloid tissue samples were collected and divided into an HBOT group (keloid with HBOT before surgery [HK] group, n = 6) and a non-HBOT group (K group, n = 6). Tumor gene expression was analyzed with an Oncomine Immune Response Research Assay kit. Data were mined with R package. The differentially expressed genes between the groups were compared. Hub genes between the groups were determined and verified with Quantitative Real-time PCR. Immune cell infiltration was analyzed based on CIBERSORT deconvolution algorithm analysis of gene expression and verified with immunohistochemistry (IHC). RESULTS: Inflammatory cell infiltration was reduced in the HK group. There were 178 upregulated genes and 217 downregulated genes. Ten hub genes were identified, including Integrin Subunit Alpha M (ITGAM), interleukin (IL)-4, IL-6, IL-2, Protein Tyrosine Phosphatase Receptor Type C (PTPRC), CD86, transforming growth factor (TGF), CD80, CTLA4, and IL-10. CD80, ITGAM, IL-4, and PTPRC with significantly downregulated expression were identified. IL-10 and IL-2 were upregulated in the HK group but without a significant difference. Infiltration differences of CD8 lymphocyte T cells, CD4 lymphocyte T-activated memory cells, and dendritic resting cells were identified with gene CIBERSORT deconvolution algorithm analysis. Infiltration levels of CD4 lymphocyte T cell in the HK group were significantly higher than those of the K group in IHC verification. CONCLUSION HBOT affected tumor gene expression and immune cell infiltration in keloids. CD4 lymphocyte T cell, especially activated memory CD4+T, might be the key regulatory immune cell, and its related gene expression needs further study.
Gene Expression ; Humans ; Hyperbaric Oxygenation ; Keloid/therapy* ; Neoplasms ; Oxygen

BACKGROUNDKeloids have a predilection for the aural region because of the special shape of the pinna. It is difficult to resect keloids entirely and maintain a satisfactory pinnal shape. Surgical excision in combination with radiotherapy is considered to be the most efficacious treatment available for severe keloids. This study was conducted to evaluate the treatment of aural keloids with intralesional excision and immediate postoperative adjuvant radiotherapy.

METHODSForty-six patients with a combined total of 74 aural keloids were treated by intralesional excision and immediate postoperative adjuvant radiotherapy. All patients received a total dose of 20 Gy in 10 consecutive days. The time interval between keloid excision and delivery of the first radiotherapy fraction was < 24 hours in all cases. The median follow-up was 2.2 years.

RESULTSTwenty-nine patients with 48 keloids (64.9%) were highly satisfied with their outcome, and were rated as good by the surgeon. Six patients with 12 keloids (16.2%) showed general satisfaction but wanted aesthetic refinement, and these patients were rated as fair by the surgeon. Three patients with four keloids (5.4%) showed no evidence of recurrence after surgery, but disliked the result because of the discoloration and irregularity of the scar surface. These patients were rated as poor by the surgeon. Partial recurrence occurred in 8 patients with 10 keloids (13.5%). No major complications were observed.

CONCLUSIONIntralesional excision and immediate postoperative adjuvant radiotherapy is well tolerated and very effective in preventing recurrence of aural region keloids.

Adolescent ; Adult ; Combined Modality Therapy ; Ear Diseases ; therapy ; Female ; Humans ; Keloid ; therapy ; Male ; Middle Aged

With recent progress in stem cell-based research, there has been tremendous interest in stem cell-based tissue regeneration. Stem cells can be differentiated into specialized cells/tissues by growth factors and cytokines. These small molecules are thought to play an important role in both wound healing and tissue regeneration. However, their biological activity and signal transduction during tissue regeneration are poorly understood. With recent advances in signal transduction by growth factors, the receptor kinases and G protein-coupled receptors, an understanding in the underlying mechanism of how these factors regulate tissue regeneration beginning to take place. In this review, the potential underlying mechanisms of growth factor signaling in normal tissue regeneration and chronic wound healing is discussed. Thus, it is an aim to provide a basis for designing more specific therapies for tissue regeneration in the near future.
Animal ; Cell Physiology* ; Chemokines/physiology ; Chronic Disease ; Growth Substances/physiology ; Human ; Keloid/therapy ; Keloid/physiopathology ; Regeneration/physiology* ; Signal Transduction/physiology* ; Wound Healing/physiology

Keloid is a benign proliferative growth of dermal collagen which extends beyond the original wound. Although there are several available methods of treatment including intralesional corticosteroid injection, cryotherapy, surgical excision, laser therapy, pressure, radiotherapy, interferon-alpha injection and so on, no effective modality to prevent the recurrence of keloids may be present. We have done shaving excision of keloids on the earlobes of 4 patients and then recommended earring made to order for home compression over 4~5 months therapy with no recurrence for 1~3 years. It is suggested that compression therapy with earring following shaving excision may be proven to be not only a simple but effective method for prevention of recurrence after removal of keloid on the earlobe.
Collagen ; Cryotherapy ; Ear* ; Humans ; Interferon-alpha ; Keloid* ; Laser Therapy ; Radiotherapy ; Recurrence ; Wounds and Injuries

BACKGROUND: Treatments including intralesional corticosteroid injection, pressure therapy, cryotherapy, and various laser therapies have had limited success for keloids and hypertrophic scars. OBJECTIVE: This trial evaluated the efficacy of a combination of 578 nm copper bromide laser and the more traditional intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to scar color. METHODS: Keloids or hypertrophic scars of 12 Korean patients were treated five times by the combined treatment at 4-week intervals. Clinical improvement was assessed by the physicians' global assessment (PGA) comparing pre- and post-treatment photographs, as well as 4 weeks after the last treatment. Erythema intensity was quantified using a mexameter. RESULTS: Most scars showed significant clinical improvement in PGA and decreased erythema intensity after 5 treatments. All patients showed improvements in symptoms like pruritus. CONCLUSION: The combined treatment is effective for keloids and hypertrophic scars, especially when the telangiectatic portion of the scars is prominent. The adjunctive use of 578 nm copper bromide laser decreased the telangiectatic side effects of an intralesional corticosteroid injection by reducing the vascular components of scars.
Cicatrix ; Cicatrix, Hypertrophic* ; Copper* ; Cryotherapy ; Erythema ; Humans ; Keloid* ; Laser Therapy ; Pilot Projects* ; Pruritus

BACKGROUND: Keloid is one of the most frustrating clinical problems in wound healing. There are numerous treatments for keloids such as surgical excision, steroid injection, radiation therapy, laser, silicone gel application and so on. Surgical excision of a keloid is generally not accepted as a first treatment of choice. However, there have been many reports of successful cosmetic results from specialized surgical treatments such as intra-lesional/intra- marginal excision with or without post surgical adjuvant treatments. OBJECTIVE: The aims of this study areto evaluate the effectiveness of intralesional excision of keloids, the optimal surgical conditions and the proper adjuvant therapy after surgery. METHODS: We analyzed the medical records and clinical photographs of 20 patients who underwent intra-lesional excision of their keloids and who had regular follow-ups for at least for 3 months. The clinical outcomes were assessed by three independent physicians based on their interpretation of the photographs before and after surgery with using a global assessment 5 point scale that ranged from bad, poor, fair and good to excellent. RESULTS: General surgical outcomes after intra-lesional excision: the average improvement score was 4.05 after intra-lesional excision and adjuvant therapy. The average improvement score after intra-lesional excision was 4.71 for ear keloids and 2.83 for keloids in other areas (p=0.000). The average improvement score after intra-lesional excision was 5 for earlobe keloids and 4.42 for ear-helix keloids (p=0.014). The average improvement score was 3.92 for the steroid intra-lesional injection and topical silicone gel combination treatment group after intra-lesional excision and the average improvement score was 4.29 for the single topical silicone gel treatment group (p=0.858). CONCLUSION: Although surgery is not a first treatment of choice for the management of keloids, large recalcitrant keloids need massive surgical removal for faster clinical results. In this study, we found that surgery, and especially intra-lesional excision, is not an absolute contraindication for treating keloids and this is sometimes considered as the first treatment of choice, and especially for ear keloids. However, a more careful surgical approach is necessary for the case of keloids that develop in other areas. Further studies about the optimal surgical indications for keloids and the recommended adjuvant therapy after surgery are necessary.
Cosmetics ; Ear ; Follow-Up Studies ; Humans ; Keloid ; Laser Therapy ; Medical Records ; Silicone Gels ; Wound Healing

A 45-year-old woman presented with keloidal nodules induced by moxibustion, which is made from mugwort powder. Keloids are benign hyperproliferative tumors of dermal connective tissue which usually result from excessive responses to cutaneous trauma in predisposed individuals. The lesions tend to occur on the upper part of the body as firm, raised tumors with a glassy surface and well demarcated borders. There are several available methods of treatment including intralesional corticosteroid injection, cryotherapy, surgical excision, laser therapy, pressure, radiotherapy and interferon-alpha injection. We report a case of a moxibustion-induced keloid in a 45-year-old female patient, who presented with multiple, round-shaped, erythematous to skin-colored, firm, cicatricial nodules on the moxibustion-applied sites.
Artemisia ; Connective Tissue ; Cryotherapy ; Female ; Humans ; Interferon-alpha ; Keloid* ; Laser Therapy ; Middle Aged ; Moxibustion ; Radiotherapy