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Therapeutics in Dermatology
A reference textbook in dermatology

  Health professionals

1 - INTRODUCTION

Keloids represent benign fibroproliferative tumors clinically presenting as raised erythematous dermal lesions, which may arise as a result to skin trauma and are a significant cause of physical, psychological and social burden for patients. A prolonged or excessive inflammatory phase of wound healing is believed to be the onset of excessive scarring with increased fibroblast proliferation and collagen synthesis. Overexpression of transforming growth factor-beta, vascular endothelial growth factor and connective tissue growth factor are important mediator in this process. Keloids are more frequent among the Hispanics and Africans with a prevalence of 5 to 16%. These finding suggest a genetic predisposition.

Classic definitions distinguish keloids from hypertrophic scars considering them as two separate entities both clinically and pathologically, according to Table I. However, recent data suggest that the clinical differences between keloids and hypertrophic scars merely reflect differences in the intensity, frequency, and duration of the inflammation of the reticular dermis.

Nevertheless, because of high recurrence rates with keloids, distinction between keloids and hypertrophic scars remains an important issue before performing any surgery or laser therapy.

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