Keloid

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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
Site skin
Clinical history typically dark skinned individuals
Prognosis benign
Treatment intralesional steroid, radiotherapy, surgery
Keloid
External resources
Wikipedia keloid
Hypertrophic scar redirects here.

Keloid is an uncommon abnormal scarring.

General

  • Sites of previous trauma/surgery, esp. in dark skinned individuals.[1]
  • Various treatments:
    • Surgery.
    • Radiotherapy.
    • Injections: corticosteroid such as triamcinolone acetonide (Kenalog).[2][3]

Note:

  • Reported as "keloidal-type collagen"; the clinician decides between hypertrophic scar and keloid.

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.[4]

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. ↑ 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.
  2. ↑ 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.
  3. ↑ 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.
  4. ↑ 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/.
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