The natural history and spontaneous resolution of keloid scars

見習醫師:吳易儒醫師指導醫師:鄭旭棠醫師

Plast Reconstr Aesthet Surg. 2014 Jan;67(1):87-92

Background

● Limited information of natural history and prognosis of keloid scars

● Provide prognostic information to patients● Baseline for future therapeutic trials

Keloid scars

● Many can’t recall injury/infection onset● Invation of surrounding dermis● Aged 10-30 years(appearance concerned)● 5th dermatological dz of black p’t in the UK● High recurrence rates ● Persist for many years● Highly variable/unpredictable growth

pattern● No gold standard therapy

Comparison of Keloid and Hypertrophic scars

Medical Quick Review of Basics http://pgmcqs.com/tag/all-india-mdms-entrance-exams-mcqs/page/7/

Meterials

Manchester Barbados Total

Patients 22 12 34

Keloid scars

83 43 126

Each patient has:-verbal consent-diagnosis of keloid disease-tx or observation at least on of their scars

Demographic and clinical characteristics of keloid patients

● Mean age: 34.5 y/o (range:21-70)Sex: Female(71%)

● Number of scars:6 scars(54%), 5 scars(36%)● Multiple scars:74%● Location:Upper limb(29%), Chest(23%), Ear

(21%)● Mechanism: Acne/chickenpox(32%), Earring

(21%), Vaccination(13%), Trauma(13%)

Results-Defined by patients

Resolution:-satisfactory of appearance/symptoms-recurrence are excludedResolving:-improving with treatment either appearance/symptomsActive scar:-continue to grow/symptoms-not improving with treatment

Result- Numbers of resolved scars

Result- Years of resolution

Result- Reasons of resolution

library.med.utah.edu www.rejuven8cosmetix.com.au

Conclusion

● Keloid scars can be resolved● Chronicity-Psychosocial consequences● Keloid scars can resolve spontaneously,

early in the disease● Scars didn’t resolve spontaneously may

resolve by treatment many years later

Remained questions

● What causes keloids to spontaneously resolve?

● How they differ from scars that don’t spontaneously resolve?

-Require future star’s further research-Unlock the key to adequately treatment

Thanks for your attention