Benign Skin Lesions

Keloid

What is a keloid?
When scars become thick and large rather than heal properly, they keloid.

How do I know if I will keloid?
If you already have hypertrophic scars or keloids, or if family members have a history of keloiding or hypertrophic scars, you may experience it as well.

How do you treat keloids and hypertrophic scars?
Serial steroid injections are the most common method. Adjunctive measures, like silicone sheeting, gel, or codran tape are used as well. Excision can be used along with postoperative steroids if other methods fail.

What causes keloids?
It is unclear why some areas keloid and others don't, but they typically result from trauma to the fibroblasts resulting in abnormal scarring.

What happens to a hypertrophic scar w/ triamcinolone injection?
The triamcinolone down regulates the pro-alpha 1 collagen gene. Less collagen, smaller scar. Associated complications include atrophy of subcutaneous layer and decreased pigmentation.

What’s the most common complication of intralesional (scar) triamcinolone (atrophy)?
Atrophy is the most common complication, where the skin becomes thin and shiny.
Telangiectasia, necrosis ulceration, visible deposition of steroid in the form of white flecks in the scar are also potential complications. Injections given too deeply or in doses greater than 75 mg per week may lead to cushingoid habitus.