Dermatology Book

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KeloidAka: Hypertrophic Scar

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  1. Definition
    1. General
      1. Excessive fibrous repair response to skin injury
    2. Hypertrophic scar
      1. Isolated to site of skin injury
    3. Keloid
      1. Extension of lesion beyond skin injury site
  2. Epidemiology
    1. More common in African-American descent
    2. Most common onset over age 30 years
  3. Signs
    1. Firm Papules or Nodules at or near prior skin injury
  4. Differential Diagnosis
    1. Dermatofibroma
    2. Dermatofibrosarcoma protuberans
    3. Desmoid tumor
    4. Scar Sarcoidosis
    5. Foreign body granuloma
  5. Course
    1. Hypertrophic scar
      1. Regress over time
    2. Keloid
      1. May continue to enlarge for years
  6. Management
    1. Intralesional Corticosteroid Injection
      1. Consider Cryotherapy pretreatment below
      2. Triamcinolone Acetonide 10 mg/ml
        1. Dilute in 3 cc Lidocaine 1%
        2. Repeat injection monthly
    2. Cryotherapy
      1. May be adjunct to Corticosteroid
      2. Lightly freeze hard keloid before injection
    3. Surgical Excision NOT recommended
      1. Often lesion recur larger than before
  7. Prevention
    1. Kelo-cote (silicon gel)
      1. Apply directly over wound
      2. Start once wound closure has occurred
      3. Sample protocol: Start Day 28 for 3 months

Keloid (C0022548)

Definition (MSH)A sharply elevated, irregularly shaped, progressively enlarging scar resulting from formation of excessive amounts of collagen in the dermis during connective tissue repair. It is differentiated from a hypertrophic scar (CICATRIX, HYPERTROPHIC) in that the former does not spread to surrounding tissues.
Definition (CSP)progressively enlarging scar resulting from formation of excessive amounts of collagen in the dermis during connective tissue repair; spreads to surrounding tissues.
Definition (NCI)(KEY-loyd) A thick, irregular scar caused by excessive tissue growth at the site of an incision or wound.
ConceptsAcquired Abnormality (T020)
ICD9701.4, 701.4
MSHD007627
EnglishCheloid, Cheloid of skin, Keloid, Keloid cicatrix, Keloid of skin, Keloid scar, Keloid scar of skin, keloid skin disorder, KELOIDS
Spanishcicatriz queloide cutanea, cicatriz queloide de la piel, queloide, queloide cutaneo, queloide de la piel
Parent Conceptsskin disorder (C0037274), Other hypertrophic and atrophic conditions of skin (C0157727), Cicatrization (C0008767), Collagen Diseases (C0009326), Reactive Cutaneous Fibrous Lesion (C1335666), Scar Tissue (C0241158), Excessive repair (C0334161), Duplicate concept (C1274013)
SourcesCOSTAR, CSP, CST, DXP, ICD9CM, MEDLINEPLUS, MSH, MTHICD9, NCI, NDFRT, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Cicatrix, Hypertrophic (C0162810)

Definition (MSH)An elevated scar, resembling a KELOID, but which does not spread into surrounding tissues. It is formed by enlargement and overgrowth of cicatricial tissue and regresses spontaneously.
ConceptsAcquired Abnormality (T020)
ICD9701.4
MSHD017439
EnglishHypertrophic Cicatrices, Hypertrophic Cicatrix, Hypertrophic Scar, Hypertrophic scar of skin, Hypertrophic Scars
Spanishcicatriz hipertrofica, cicatriz hipertrofica de la piel
Parent ConceptsCicatrization (C0008767), Reactive Cutaneous Fibrous Lesion (C1335666), Scar conditions and fibrosis of skin (C0036278), Ambiguous concept (C1274012)
SourcesMSH, MTHICD9, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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