The efficacy of complete surgical excision of keloid and piercing sinus tract on earlobe keloid.

摘要: Dear Editor: The external ear is one of the most common sites for keloid formation. Many different treatment modalities such as surgical excision, intralesional corticosteroids, radiotherapy and pressure earrings have been used earlobe keloids1. Among them, excision either a monotherapy or part combination therapy. It thought that recurrence rate keloids after with higher than This study evaluated efficacy complete keloids. was approved by institutional review boards Kyungpook National University Hospital. We retrospectively reviewed 20 patients treated (Fig. 1) regardless clinical subtypes1 (anterior button, posterior dumbbell, wraparound, lobular) from January 2000 to May 2012 in our clinic. In this study, designed total removal keloidal mass piercing sinus tract. Earlobe were diagnosed histopathological examination. We also 15 who surgery post-surgical adjunctive The compared addition, subtypes, age, accompanying size assessed their effect on excision. Statistical analysis performed using chi-square Fisher's exact tests. A p<0.05 considered be statistically significant. Fig. 1 Complete keloid. tract, which indicated yellow arrows, should totally removed. If not, remaining tract may become cause relapse. The age (the ratio male female 0 : 20) variable (ages 16 52 years; mean 25.3 years) (Table 1). All histopathology confirmed characteristics well present. Fifteen postsurgical therapy consisted 12 females 3 males 61 age: 28.2 Adjunctive included injection corticosteroid, radiotherapy, earrings, application 5-fluorouracil mitomycin C. 20% (4 out 20). 1-year follow-up 27% 15). 40% (6 42% (5 12). There no significant difference between two groups (p>0.05). Differences according subtype, not Keloids chest shoulder are relatively resistant treatment, high rates single therapeutic modality. need differently other show lower tension covered keratinocytes. authors noted earlobe2,3. current (27% at follow-up). superior outcome likely results skin region intrakeloidal observations wounds subjected increased more form fleshy tissue makes closure without easier accomplish1. Moreover, discontinuation wearing reduces weight earrings. Mechanical capable inducing several cell functions, including stimulation gene expression, protein synthesis proliferation4-7. recent revealed there formation focal adhesion complexes fibroblasts had expression transformation growth factor (TGF)-β1, TGF-β2, collagen I normal fibroblasts8. leading edge irritation role keratinocytes interest because only do they secrete autocrine proteins, but cytokines paracrine-like fashion into extracellular domain induce local proliferative, metabolic immunologic activities. One influence keloid-derived proliferation an vitro serum-free coculture system. considerable increase cocultured keratinocytes, keratinocyte controls9. strongly suggests might important pathogenesis producing signals stimulate underlying dermis proliferate produce matrix9. data suggested keloid, center where process has already burned out10. would suggest help prevent keloid. Table 1 Patient demographics In all removed statistical significance subtype. could find (2 teenagers, 14 20s, 2 30s, 1 her 40s 50s), keloid) (8 less 1.0 cm over size). This showed low believe these come decrease keloid-promoting factors, reduction tissues. Additional factors further