Keloids (keloid scar)

Overview

Keloid (keloid scar) was first described by Jean-Louis aliber in 1806. The name of the disease is obtained from the word chele (Greek. claw crab), which stresses the lateral germination of new tissue in normal skin.

Keloid scar or keloid, is typically greater than the volume size of the primary injury has a shiny surface pale pink (in skin tone) saturated or whitish pink color. Settles, speaking over the intact skin to 5-8 mm. Localization is diverse, often a skin with low functionality - earlobes, chest and shoulders. Keloids and may appear on the face and neck.

Risk to life and health they are not, but cause physical and aesthetic discomfort. Children and the elderly are rare. Among middle-aged people often affects women.

Causes

The basis of keloid scars - excessively increasing the connective tissue

. It contains a huge excess amount (atypical) fibroblasts. They produce extracellular contents - collagen precursors, elastin and mucopolysaccharides. The keloid fibroblasts are active for a long time.

The etiology of keloids of today is not clear, but the basic triggers:

• genetic predisposition;
• pronounced pigmentation of the skin;
• pregnancy;
• puberty;
• infection of the wound during healing;
• immune disorders (eg, systemic lupus erythematosus);
• hormonal imbalance in the body;
• tattooing, body piercing.

Classification

Distinguish keloids spontaneous and secondary. First developed on intact skin, the second - on the site of damage.

Classification somewhat arbitrary, since microdamages may go unnoticed. Often the damage does not include the elements of acne, insect bites, although in fact the normal structure of the skin is also disturbed.

In developing keloid scars are 4 steps:

• Epithelialization - wound site is formed on primary film epithelium during the week it coarsens and compacted.
• Swelling - scar size increases, it rises above the surface of the skin becomes sensitive or painful to the touch.
• Seal - the formation of the actual keloid.
• Softening - the disappearance of pain and blanching.

symptoms

Formation of keloids begins in a few months (one year) after epithelialization of the wound. Accompanied by such signs:

• pruritus, especially by rubbing or scratching;
• pain or discomfort when pressed;
• change in sensitivity skin lesion - paresthesia;
• redness.

At the site of the injured skin area formed scar that exceeds the size and shape coinciding with damage. He dense, does not resolve with time.

Diagnostics

The diagnosis is usually straightforward thanks to the characteristic type of keloid scars. The specialist will examine and ask how long ago, and then began to change.

Keloid differentiate from hypertrophic scars, Dermatofibroma, dermatofibrosarcoma. biopsy is indicated for any doubt.

Treatment

A single treatment strategy to date, no. The physician defines the appropriate methods based on the condition of the patient and his own experience. Are used:

• Silicone gel (or plate). It allows you to squeeze the capillaries, reduce the flow of inflammatory agents to reduce the synthesis of collagen, making keloid growth stops.
• Compression - clamping capillary high pressure to also stop the growth of keloid.
• Corticosteroids. Hormonal drugs are injected either into the scar itself or in the tissue around it. Under the influence of hormones stops dividing fibroblast collagenase increases the concentration - an enzyme that breaks down collagen.
• Cryodestruction - the destruction of keloid cells and their organelles ultralow temperatures.
• Ointment therapy - a helper method is based on the healing bactericidal ointment components.
• Radical methods of treatment - surgical excision and laser destruction.

When surgical removal of keloids is important to get rid not only on the scar, but also the surrounding tissue to prevent the recurrence of keloid. The extent of the re-emergence of keloid after surgery is very high - up to 90%, because today this method is rarely used.

Laser correction It allows you to accurately calculate the amount of tissue removed. Here relapses less - up to 40%.

prevention

Preventive recommendations to prevent the formation of keloid:

• adequate care for scars in the postoperative period;
• protection of damaged skin from direct sun, the use of cosmetics with high UV protection;
• piercing procedures (. ears, lips, eyebrows, nose, etc.) must be carried out by a specialist in compliance with all health regulations; unacceptable to use piercing gun with small earrings-carnations - they close the wound on both sides, preventing the care of her;
• carrying out tattooing - and only in compliance with the health standards;
• timely processing of all skin lesions.

If previously the patient has already been keloid scars, or they arose in some of the next of kin, the injectable cosmetic treatments, body piercing and tattoos it is contraindicated.

Forecast

keloid treatment is more effective the earlier you start. Hormone therapy, cryotherapy and compression methods show good results.

Inveterate scars are difficult to treat. The event of failure keloid It can grow to very large sizes.

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