Numerous reports on the incidence of keloids in the Black population vary anywhere between 5 and 15%7-9 In a review of 175 cases of keloids from various races, Alhady and Sivanantharajah found that keloids were 15 times more likely to occur in darker-skinned individuals.įigure 1 Hypertrophic scar of a Nuba man., (With permission.)Īlthough keloids can occur at any age, they are most likely to occur between the ages of 10 and 30 years. The exact incidence of keloids and HTSs remains unknown. It is imperative that the reconstructive surgeon differentiates among these three forms, as they require different treatment modalities. 2C).6 Scar contractures typically appear as a fixed, rigid scar that con-tributes to both cosmetic and functional problems. By definition, a scar contracture is the result of a contractile wound-healing process occurring in a scar that has already been reepithelialized and adequately healed (Fig. An additional form of abnormal wound healing is the scar contracture. A keloid, on the other hand, is characterized by its ability to spread outside the boundaries of the original lesion (Fig. By their definition, an HTS is described as a fibrous tissue outgrowth with excessive scarring that re-mains within the confines of the wound (Fig.
have provided us with the description of hypertrophic scars and keloids that is commonly used today.
The root "Chele" is adopted from the Greeks and means "crab claw." This describes the keloid lateral outgrowths and crablike extensions into surrounding tissue}'4 1).2 The term Cheloide was initially described by Alibert in the early 1800s. The first description of keloids dates back to approximately 1700 be in the ancient Egyptian writing of the Smith Papyrus documents.' Even today, African sculptures, drawings, and body scarification depict various patterns developing from hypertrophic scars that may indicate kinship, stature, or acts of bravery (Fig. Keloids and hypertrophic scars (HTSs) are fibrous tissue outgrowths that result from a derailment in the normal wound-healing process. KEYWORDS: Contracture, hypertrophic, keloid, scar All treatment protocols are individualized, but the standard approach to keloids and HTSs begins with corticosteroid injection followed by surgical excision, pressure dressings, and long-term follow-up. Treatment begins by educating the patient about the etiology of the scarring process.
SCARS ON 45 1999 SKIN
A combination of biochemical factors, skin tension, endocrinologic factors, and genetic factors are the likely culprits. Beyond the common belief that trauma is the initiating event of keloid and hypertrophic scar formation, the remainder of the process remains uncertain. Keloids and hypertrophic scars (HTSs) are fibrous tissue outgrowths that result from a derailment in the normal wound-healing process. Sherris, M.D.Ī scar contracture is the result of a contractile wound-healing process occurring in a scar that has already been re-epithelialized and adequately healed.
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