A Comparative Study on Recurrence of Earlobe Keloids after Postoperative Adjuvant Therapy / 대한피부과학회지

BACKGROUND: Earlobe keloids are a cosmetically and symptomatically bothersome clinical problem with frequent recurrence despite various treatments including surgical excision and intralesional injection of corticosteroids. OBJECTIVE: The aim of this study was to compare the results and recurrence of earlobe keloids after various postexcisional adjuvant therapies and to identify the most effective postoperation adjuvant therapy. METHODS: We retrospectively evaluated 36 patients with earlobe keloids (n=71) who underwent core excision and a suprakeloidal flap using photographs. One group did not have adjuvant therapy, one group was treated with adjuvant triamcinolone intralesional injection (TRA/ILI), and another group was treated with postoperative irradiation. RESULTS: Among treated 71 keloids, 18 lesions (25.4%) recurred; 42.9% (12/28) of the operation-only group and 19.4% (6/31) of TRA/ILI group showed recurrence. The adjuvant radiation therapy group had no recurrence. The difference in recurrence rate was statistically significant. CONCLUSION: Postexcisional adjuvant therapy was more effective than excision monotherapy for keloid treatment, and radiation therapy had more sustained effects than that of TRA/ILI.

Surgery and Perioperative Intralesional Corticosteroid Injection for Treating Earlobe Keloids: A Korean Experience

BACKGROUND: The aesthetic implications of ear keloids, which affect people of all races, are serious and the treatment of earlobe keloids is known to be difficult. The high rate of recurrence following excision alone has led to investigating various types of adjuvant therapy, including intralesional corticosteroid injection. OBJECTIVE: We evaluated the efficacy of excision combined with perioperative intralesional triamcinolone acetonide injection for treating earlobe keloids of Korean patients. METHODS: From 1997 to 2006, eighteen keloids on the earlobes of fifteen Korean patients were treated. The patient age ranged from 15 to 32 years (mean age: 24 years). All the patients were female and the keloids occurred after ear piercing. Preoperative intralesional triamcinolone acetonide (TA) injection was administered twice at a 1-month interval. Postoperative intralesional TA injections were given every 1 month for several months, depending on the patient's clinical progress. RESULTS: The follow-up period ranged from 4 to 42 months (mean: 18.5 months). After the surgery, TA intralesional injections were given 2 to 13 times (mean: 5.2 times). Of the treated keloids, eleven showed good results (61.1%) and three recurred (16.6%). No complications from the TA intralesional injection were observed. CONCLUSION: Among the various treatments for earlobe keloids, we suggest that excision with corticosteroid intralesional injection can be used as the first line therapy when considering its effect and economic advantage.

Three Cases of Earlobe Keloids Treated with Carbon Dioxide Laser Vaporization and Pressure Earring after Partial Keloidectomy / 대한피부과학회지

Keloid is proliferative fibrous growths that result from an excessive tissue response to trauma. The earlobe is a common site for the formation of keloid and the frequent cause is ear piercing. Many modalities are available for the treatment of earlobe keloid. Surgical excision has been the most commonly used therapeutic modality but recurrence following excision is common. Intralesional triamcinolon, radiation therapy, compression device, cryosurgery, D-penicillamine or any combination of them were reported to be successful in the treatment of earlobe keloid. We report three cases of earlobe keloid treated with partial surgical keloidectomy of upper part and carbon dioxide laser vaporizing the residual keloid tissue. And then the defect was covered with a primary closure with flap. Pressure earrings were fitted 2 weeks after surgery, and were maintained for 3 months. There was no recurrence of keloid for follow-up period at least 9 months. We suggest that combined modality of CO2 laser vaporization and pressure earring after surgical keloidectomy may offer a better cosmetic and functional improvement in the treatment of primary and recurrent earlobe keloid.