Difference between revisions of "Keloid"
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| Micro = thick collagen bundles - surrounded by paler staining fibroblasts, loss of adnexal structures | | Micro = thick collagen bundles - surrounded by paler staining fibroblasts, loss of adnexal structures | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = hypertrophic scar | | LMDDx = hypertrophic scar, keloidal [[dermatofibroma]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
| Line 17: | Line 17: | ||
| Assdx = | | Assdx = | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = typically dark skinned individuals | | Clinicalhx = typically dark skinned individuals, prior trauma, burn or surgery | ||
| Signs = | | Signs = | ||
| Symptoms = | | Symptoms = | ||
| Line 27: | Line 27: | ||
| Other = | | Other = | ||
| ClinDDx = | | ClinDDx = | ||
| Tx = intralesional steroid, radiotherapy, surgery | |||
}} | |||
{{ Infobox external links | |||
| Name = {{PAGENAME}} | |||
| EHVSC = | |||
| EHVSC_mult = | |||
| pathprotocols = | |||
| wikipedia = keloid | |||
| pathoutlines = | |||
}} | }} | ||
:''Hypertrophic scar'' redirects here. | :''Hypertrophic scar'' redirects here. | ||
'''Keloid''' is an uncommon abnormal [[scar|scarring]]. | '''Keloid''' is an uncommon abnormal [[scar|scarring]] of the [[skin]] that extends beyond the boundaries of the initial injury. | ||
==General== | ==General== | ||
*Sites of previous trauma/surgery, | *Sites of previous trauma/surgery/burn, especially in dark skinned individuals.<ref name=Ref_WMSP492>{{Ref WMSP|492}}</ref> | ||
*Various treatments: | |||
**Surgery. | |||
**Radiotherapy. | |||
**Injections: corticosteroid such as triamcinolone acetonide (''Kenalog'').<ref name=pmid26758090>{{Cite journal | last1 = Acosta | first1 = S. | last2 = Ureta | first2 = E. | last3 = Yañez | first3 = R. | last4 = Oliva | first4 = N. | last5 = Searle | first5 = S. | last6 = Guerra | first6 = C. | title = Effectiveness of Intralesional Triamcinolone in the Treatment of Keloids in Children. | journal = Pediatr Dermatol | volume = 33 | issue = 1 | pages = 75-9 | month = Jan | year = 2016 | doi = 10.1111/pde.12746 | PMID = 26758090 }}</ref><ref name=pmid25396172>{{Cite journal | last1 = Trisliana Perdanasari | first1 = A. | last2 = Lazzeri | first2 = D. | last3 = Su | first3 = W. | last4 = Xi | first4 = W. | last5 = Zheng | first5 = Z. | last6 = Ke | first6 = L. | last7 = Min | first7 = P. | last8 = Feng | first8 = S. | last9 = Zhang | first9 = YX. | title = Recent developments in the use of intralesional injections keloid treatment. | journal = Arch Plast Surg | volume = 41 | issue = 6 | pages = 620-9 | month = Nov | year = 2014 | doi = 10.5999/aps.2014.41.6.620 | PMID = 25396172 }}</ref> | |||
Note: | |||
*Reported as "keloidal-type collagen"; the clinician decides between ''hypertrophic scar'' and ''keloid''. | |||
**A keloid grows beyond the boundaries of the injury site,<ref name=pmid19608056>{{Cite journal | last1 = Kelly | first1 = AP. | title = Update on the management of keloids. | journal = Semin Cutan Med Surg | volume = 28 | issue = 2 | pages = 71-6 | month = Jun | year = 2009 | doi = 10.1016/j.sder.2009.04.002 | PMID = 19608056 }}</ref> a hypertrophic scar does not. | |||
==Gross== | |||
*Scar formation beyond the initial injury site. | |||
===Image=== | |||
<gallery> | |||
Image:Keloid.jpg |Keloid. (WC) | |||
</gallery> | |||
==Microscopic== | ==Microscopic== | ||
Features:<ref name=Ref_WMSP492>{{Ref WMSP|492}}</ref> | Features:<ref name=Ref_WMSP492>{{Ref WMSP|492}}</ref> | ||
| Line 42: | Line 64: | ||
DDx: | DDx: | ||
*Hypertrophic scar.<ref name=pmid20927486>{{Cite journal | last1 = Gauglitz | first1 = GG. | last2 = Korting | first2 = HC. | last3 = Pavicic | first3 = T. | last4 = Ruzicka | first4 = T. | last5 = Jeschke | first5 = MG. | title = Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. | journal = Mol Med | volume = 17 | issue = 1-2 | pages = 113-25 | month = | year = | doi = 10.2119/molmed.2009.00153 | PMID = 20927486 | PMC = 3022978 }}</ref> | *Hypertrophic scar.<ref name=pmid20927486>{{Cite journal | last1 = Gauglitz | first1 = GG. | last2 = Korting | first2 = HC. | last3 = Pavicic | first3 = T. | last4 = Ruzicka | first4 = T. | last5 = Jeschke | first5 = MG. | title = Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies. | journal = Mol Med | volume = 17 | issue = 1-2 | pages = 113-25 | month = | year = | doi = 10.2119/molmed.2009.00153 | PMID = 20927486 | PMC = 3022978 }}</ref> | ||
*[[Dermatofibroma]] - esp. ''keloidal dermatofibroma''.<ref name=pmid9591726>{{Cite journal | last1 = Kuo | first1 = TT. | last2 = Hu | first2 = S. | last3 = Chan | first3 = HL. | title = Keloidal dermatofibroma: report of 10 cases of a new variant. | journal = Am J Surg Pathol | volume = 22 | issue = 5 | pages = 564-8 | month = May | year = 1998 | doi = | PMID = 9591726 }}</ref> | |||
===Images=== | ===Images=== | ||
Latest revision as of 14:16, 28 February 2017
| Keloid | |
|---|---|
| Diagnosis in short | |
 Keloid. H&E stain. | |
|
| |
| LM | thick collagen bundles - surrounded by paler staining fibroblasts, loss of adnexal structures |
| LM DDx | hypertrophic scar, keloidal dermatofibroma |
| Site | skin |
|
| |
| Clinical history | typically dark skinned individuals, prior trauma, burn or surgery |
| Prognosis | benign |
| Treatment | intralesional steroid, radiotherapy, surgery |
| Keloid | |
|---|---|
| External resources | |
| Wikipedia | keloid |
- Hypertrophic scar redirects here.
Keloid is an uncommon abnormal scarring of the skin that extends beyond the boundaries of the initial injury.
General
- Sites of previous trauma/surgery/burn, especially in dark skinned individuals.[1]
- Various treatments:
Note:
- Reported as "keloidal-type collagen"; the clinician decides between hypertrophic scar and keloid.
- A keloid grows beyond the boundaries of the injury site,[4] a hypertrophic scar does not.
Gross
- Scar formation beyond the initial injury site.
Image
Keloid. (WC)
Microscopic
Features:[1]
- Thick collagen bundles - surrounded by paler staining fibroblasts - key feature.
- Lesion replaces adnexal structures, e.g. hair, sweat glands.
DDx:
- Hypertrophic scar.[5]
- Dermatofibroma - esp. keloidal dermatofibroma.[6]
Images
Keloid - low mag. (WC/Nephron)
Keloid - intermed. mag. (WC/Nephron)
Keloid - high mag. (WC/Nephron)
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SKIN LESION, LEFT SCAPULA, EXCISION: - DERMAL SCAR WITH KELOIDAL-TYPE COLLAGEN, SEE COMMENT. COMMENT: The findings are consistent with a hypertrophic scar or keloid; clinical correlation is required.
Clinical provided
SKIN LESION, LEFT NIPPLE AREOLA, EXCISION: - DERMAL SCAR WITH KELOIDAL-TYPE COLLAGEN, CONSISTENT WITH HYPERTROPHIC SCAR.
See also
References
- ↑ 1.0 1.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 492. ISBN 978-0781765275.
- ↑ Acosta, S.; Ureta, E.; Yañez, R.; Oliva, N.; Searle, S.; Guerra, C. (Jan 2016). "Effectiveness of Intralesional Triamcinolone in the Treatment of Keloids in Children.". Pediatr Dermatol 33 (1): 75-9. doi:10.1111/pde.12746. PMID 26758090.
- ↑ Trisliana Perdanasari, A.; Lazzeri, D.; Su, W.; Xi, W.; Zheng, Z.; Ke, L.; Min, P.; Feng, S. et al. (Nov 2014). "Recent developments in the use of intralesional injections keloid treatment.". Arch Plast Surg 41 (6): 620-9. doi:10.5999/aps.2014.41.6.620. PMID 25396172.
- ↑ Kelly, AP. (Jun 2009). "Update on the management of keloids.". Semin Cutan Med Surg 28 (2): 71-6. doi:10.1016/j.sder.2009.04.002. PMID 19608056.
- ↑ Gauglitz, GG.; Korting, HC.; Pavicic, T.; Ruzicka, T.; Jeschke, MG.. "Hypertrophic scarring and keloids: pathomechanisms and current and emerging treatment strategies.". Mol Med 17 (1-2): 113-25. doi:10.2119/molmed.2009.00153. PMC 3022978. PMID 20927486. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022978/.
- ↑ Kuo, TT.; Hu, S.; Chan, HL. (May 1998). "Keloidal dermatofibroma: report of 10 cases of a new variant.". Am J Surg Pathol 22 (5): 564-8. PMID 9591726.