BACKGROUND: Keloids and hypertrophic scars represent excessive scarring. They require different therapeutic approaches, which can be hampered because of an apparent lack of morphologic difference between the two diseases. OBJECTIVE: This study investigated the clinical and dermoscopic features of keloids and hypertrophic scars in order to help dermatologists distinguish these lesions better. METHODS: A total of 41 keloids and hypertrophic scars in 41 patients were examined clinically and by performing dermoscopy with a digital imaging system. Lesions were evaluated for vascular structures. RESULTS: Dermoscopy revealed vascular structures in most keloid lesions (90%) but in only 27% of hypertrophic scar lesions. The most common dermoscopic vascular structures in keloids were arborizing (52%), followed by linear irregular (33%) and commashaped (15%); these features were present but less evident in hypertrophic scars (9% for all types). The distribution frequency of the vascular structures differed significantly between diseases (p<0.001). CONCLUSION: A strong association of vascular structures with keloids was observed on dermoscopic examination. The results suggest dermoscopic examination of vascular structures is a clinically useful diagnostic tool for differentiating between keloids and hypertrophic scars.
Blood Vessels ; Cicatrix ; Cicatrix, Hypertrophic* ; Dermoscopy* ; Humans ; Keloid*

BACKGOUND: Pulsed dye laser (PDL) is recommended as a good treatment for scars and keloids. However, there has been no absolute indications and standard laser parameters. Some proposed that only hypertrophic and atrophic/flat scars were effectively treated, but others reported that all scars and even keloids responded well to PDL treatment. OBJECTIVE: To determine whether 595nm PDL treatment is effective for scars and keloids, and if so, which group responds better to treatment between the atrophic/flat scars group and hypertropic scars/keloids group. METHOD: Twenty-two patients (skin types III-V) with scars and keloids were treated with 595nm PDL (0.45 or 1.5 msec, 4-8J/cm(2), 7mm spot size). Eleven patients had hypertrophic scars/keloids (6 had hypertropic scars, 5 had keloids), and eleven patients had atrophic/flat scars. After several treatments of each lesion, the results were evaluated by extent of the patient's satisfaction and comparision of pre-and post-laser photography and divided into the four categories: excellent, good, fair and poor. RESULTS: The clinical improvement and patient's satisfaction were better in the atrophic/flat scars group than the hypertrophic scars/keloid group. With keloid potients, the result of treatment were found to be particularly poor. CONCLUSION: From our results, only atrophic/flat scars respond well to 595nm PDL treatment, and hypertrophic scars and keloids should be excluded from this treatments method.
Cicatrix* ; Cicatrix, Hypertrophic ; Humans ; Keloid* ; Lasers, Dye* ; Photography

A 43-year-old man presented with well-defined purple to skin-colored 2X1cm sized plague and various sized papules on the posterior neck. Histopathological findings were follicular and perifollicular inflammation with plasma cells, lymphocytes and neutrophils and dermal fibrosis shown as hypertrophic scar tissue. The patient was diagnosed as acne keloidalis nuchae and treated by surgical excision. We report a case of acne keloidalis nuchae showing typical clinical and histopathological findings.
Acne Keloid* ; Acne Vulgaris* ; Adult ; Cicatrix, Hypertrophic ; Fibrosis ; Humans ; Inflammation ; Lymphocytes ; Neck ; Neutrophils ; Plague ; Plasma Cells

There is more incidence of epicanthal fold in oriental and sometimes the epicanthal fold serves as an unacceptable appearence, so many seek cosmetic improvement in the medial canthal area to eliminate the epicanthal folds. Epicanthoplasty can give the aesthetic improvement by lenthening the palpebral fissure, thus producing the image of a larger and open-eye and especially it can enhance the aesthetic result of the double-lid procedure, but the epicanthal area is delicate and prone to produce a noticeable scar after epicanthoplasty, which is due to multiple incision and undue tension during the epicanthoplasty. We present a simple, tension free, and reproducible method of Z-epicanthoplasty based on our experience with 84 cases performed during the past 10 months in oriental eyelids. The advantages of this procedure are simplicity in design and minimal scaring produced in the medial canthal area without fear of hypertrophic scar as compared with complexed W-plasty, four flap, or Y-V plasty, which require multiple incision or undue tension and often creates unsightly scarring.
Cicatrix ; Cicatrix, Hypertrophic ; Eyelids ; Incidence

No abstract available.
Cicatrix, Hypertrophic* ; Skin*

No abstract available.
Cicatrix, Hypertrophic ; Toes

In the East, Probably one of the most commonly performed esthetic operation is the piercing of the earlobes for earring. the complication of this procedure includes infection, the formation of the hypertrophic scar or keloid, and tearing. Keloid formation is one of the disaterous common complications of the ear piercing. the patients regard the keloid as a cosmetic blemish and they complain that they cannot wear earrings. We have experienced 5 patients of earlobe keloid complicated from piercing of the earlobes. We used intralestional steroid njection, in conjunction with surgical excision and pressure therapy for treatment of the keloid. Among various techniques for reconstructing a piercing, we chose modified Pardue's method for artificial earlobe cleft after wide excision of the keloid. the result was good and satisfactory without any complication after 4 to 24 months of follow-up. the purpose of this paper is to present a simple method of treatment of the earlobe keloid with preservation of the perforation for an earring.
Body Piercing ; Cicatrix, Hypertrophic ; Ear* ; Follow-Up Studies ; Humans ; Keloid*

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

Keloids are fibrous overgrowth resulting from abnormal wound healing processes at the site of cutaneous injury. It extends beyond the confines of the original wound, begins later after injury, and does not regress with time contrary to hypertrophic scar. The gold standard has not been established in the treatment of keloids, yet. Excision of keloid alone showed a high rate of recurrence (45-100%). Recently, we have experienced two keloidal masses in the auricle (one on helix, the other on lobule), which were treated with surgery and adjuvant steroid injection. We developed an anteriorly-based skin flap from the skin covering of the keloidal mass and used it for several reasons. We also used triamcinolone injection after the surgery. In this paper, we are presenting the result of these cases with a review of literature.
Cicatrix, Hypertrophic ; Keloid* ; Recurrence ; Skin ; Triamcinolone ; Wound Healing ; Wounds and Injuries

A case of acne conglobata associated with hidradenitis suppurativa, dissecting cellulitis and disseminated superficial actinic porokeratosis in 44 year-old man is presented with brief review of literature. The patient had acne vulgaris for a few years during his highschool days, about 5 years prior to the development of such a typical lesions of acne conglobata as multiple comedones, papules, pustules, abscesses, cysts and draining sinnses and subsquent hypertrophic scars and keloids. We are ps,rticularly interested in association of hidradenitis suppurativa and dissecting cellulitis with ance conglobata that comprise follicular occlusion triad in tbis teint. The pstient was treztei with systemic antibiotics and corticosteroids injections and surgical interventions with considerable improvement.
Abscess ; Acne Vulgaris* ; Adrenal Cortex Hormones ; Adult ; Anti-Bacterial Agents ; Cellulitis ; Cicatrix, Hypertrophic ; Hidradenitis Suppurativa ; Humans ; Keloid ; Porokeratosis