The polyphasic Protocol for the Keloid

Abstract

The occurrence of keloids is a common clinical problem that can cause functional impairment and cosmetic deformities. They are pathological cutaneous scars that occur due to surgery, burns or other traumatic wounds. Keloids are manifestations of a loss of the control mechanism that regulates wound repair (inflammation, neoangiogenesis and synthesis of extracellular matrix). The authors present their polyphasic protocol for the treatment of keloids: it consists of a combination of intralesional excision, steroid injections and dye-laser treatment over a period of four months. In our research, we have selected patients who have been clinically diagnosed to have keloid scars, which have been diagnosed for at least one year (50 patients, from January 2005 to December 2014). Our polyphasic protocol works on the different phases of the scarring process, altered in keloids; the uncontrolled process in keloid scars is kept in check by the combination of surgical and nonsurgical approaches, and is based on the knowledge on wound healing. In all cases the results obtained are satisfactory, with a keloid scar size decrease of at least 75% from the original dimensions and an improvement of the adaptation of the keloid to surrounding skin. The occurrence of keloids is a common clinical problem that can cause functional impairment and cosmetic deformities. They are pathological cutaneous scars that occur due to surgery, burns or other traumatic wounds. Keloids are manifestations of a loss of the control mechanism that regulates wound repair (inflammation, neoangiogenesis and synthesis of extracellular matrix). The authors present their polyphasic protocol for the treatment of keloids: it consists of a combination of intralesional excision, steroid injections and dye-laser treatment over a period of four months. In our research, we have selected patients who have been clinically diagnosed to have keloid scars, which have been diagnosed for at least one year (50 patients, from January 2005 to December 2014). Our polyphasic protocol works on the different phases of the scarring process, altered in keloids; the uncontrolled process in keloid scars is kept in check by the combination of surgical and nonsurgical approaches, and is based on the knowledge on wound healing. In all cases the results obtained are satisfactory, with a keloid scar size decrease of at least 75% from the original dimensions and an improvement of the adaptation of the keloid to surrounding skin.