ABSTRACT
Abstract Therapy for large symptomatic keloids is often plagued with complicated reconstruction manner and recurrence. This article reports a rare treatment combination for a chest keloid with internal mammary artery perforator flap reconstruction and radiation therapy. We excised the keloid and covered the defect with an internal mammary artery perforator flap. Immediate electron-beam irradiation therapy was applied on the second postoperative day. There was no sign of recurrence over the follow-up period of 18 months. The combination of internal mammary artery perforator flap and immediate radiation therapy is useful when faced with chest keloids of similar magnitude and intractability.
Subject(s)
Humans , Male , Middle Aged , Keloid/surgery , Mammary Arteries/transplantation , Perforator Flap/blood supply , Keloid/radiotherapy , Plastic Surgery Procedures/methods , Thorax , Treatment OutcomeABSTRACT
BACKGROUND: A 50% to 80% recurrence rate of earlobe keloids can occur following a simple excision. Many modalities, including radiotherapy, have been suggested to reduce the postoperation recurrence. OBJECTIVE: The aim of the present study was to determine the efficacy of postoperative radiotherapy by a high dose rate Iridium 192 mould in the prevention of earlobe keloids recurrence. MATERIAL AND METHOD: Between March 1999 and March 2003, 22 patients with 24 earlobe keloids were treated by radiotherapy immediately following surgical excision. A dose of 15 Gray in 3 fractions was delivered at a point placed 5 mm from the axis of the Iridium sources. RESULTS: From the 22 patients with 24 keloids who were treated, 15 patients with 16 keloids were followed for a minimum of 6 months. Recurrence occurred in two keloids (12.5%). There were no severe adverse effects. CONCLUSION: Postoperative radiotherapy by high dose rate Iridium 192 mould was an effective prevention of earlobe keloids recurrence. It was well tolerated and did not present any significant side effects.
Subject(s)
Adolescent , Adult , Ear, External/pathology , Female , Humans , Iridium Radioisotopes/therapeutic use , Keloid/radiotherapy , Male , Postoperative Period , Prospective Studies , Radiopharmaceuticals/therapeutic use , Radiotherapy, Adjuvant , Recurrence/prevention & controlABSTRACT
Los queloides son el resultado de un proceso de cicatrización patológico, en el que los fibroblastos sintetizan colágeno en forma excesiva. Aunque se han descrito algunos factores predisponentes, su etiología es desconocida. Los queloides auriculares se asocian al empleo de aros, piercing, traumatismos, quemaduras y cirugías. Además de las repercusiones estéticas y psicológicas, suelen causar dolor, prurito y parestesias. Su manejo es controvertido, habiéndose descrito modalidades quirúrgicas y no quirúrgicas de tratamiento. Aunque ninguna de ellas es efectiva en todos los casos, su asociación parece tener mejores resultados. Se presenta una serie de 9 pacientes, con 13 queloides auriculares, en los que empleamos cirugía y comprensión, como pilares del tratamiento. Finalmente proponemos un algoritmo terapéutico.
Subject(s)
Adolescent , Adult , Male , Humans , Female , Child , Middle Aged , Ear, External/injuries , Keloid/surgery , Combined Modality Therapy , Adrenal Cortex Hormones/therapeutic use , Follow-Up Studies , Keloid/drug therapy , Keloid/radiotherapy , Radiotherapy, Adjuvant , Retrospective Studies , Recurrence/prevention & controlABSTRACT
As taxas de dose superficial de dois aplicadores dermatológicos foram determinadas utilizando uma câmara de extrapolação projetada e construída no Laboratório de Calibração do IPEN. Apresenta-se neste trabalho a comparação entre as calibrações realizadas no IPEN e pelo fabricante.
Subject(s)
Strontium , Yttrium , Calibration , Cobalt/radiation effects , Dermatologic Agents/administration & dosage , Radiation Dosage , Keloid/radiotherapy , Cicatrix, Hypertrophic/radiotherapy , Skin Neoplasms/radiotherapy , Postoperative Period , Pterygium/radiotherapyABSTRACT
Breve relato das características clínicas e histológicas dos quelóides, sua diferenciaçäo das cicatrizes hipertróficas e os vários métodos de tratamento
Subject(s)
Humans , Male , Female , Aged , Adrenal Cortex Hormones/therapeutic use , Cicatrix/etiology , Cryosurgery , Keloid/etiology , Rubinstein-Taybi Syndrome/genetics , Surgery, Plastic , Collagen/metabolism , Keloid/drug therapy , Keloid/etiology , Keloid/physiopathology , Keloid/radiotherapy , Keloid/surgery , Keloid/therapy , Radiodermatitis/complications , Skin Transplantation , Tretinoin/therapeutic useABSTRACT
Durante um periodo de dois anos, 267 cicatrizes de 207 pacientes foram tratadas com radioterapia pos-operatoria. A idade mediana dos pacientes foi de 28 anos; 79,2 por cento eram mulheres e 66 por cento eram pretos oumulatos. Os pacientes foram tratados em sua quase totalidade com Rx de 100 kv, sem qualquer filtracao, recebendo uma dose de 12 Gy em seis tratamentos em dias alternados. Apos 24 meses, 62 por cento dos casos permaneceram sem queloide. A analise dos grupos de risco mostrou que houve importante diferenca ao se comparar os pacientes de raca branca com pretos e mulatos, em favor dos primeiros. Outro fator importante foram os antecedentes pessoais, embora o resultado nao tenha sido estatisticamente satisfatorio. E enfatizada a necessidade de estudos propspectivos para determinar a dose ideal para a profilaxia de queloides.
Subject(s)
Humans , Female , Male , Adult , Keloid/radiotherapy , Retrospective Studies , Risk Factors , Disease-Free Survival , Treatment OutcomeABSTRACT
Se informa que los queloides son acumulaciones exageradas de colágeno que se desarrollan en la dermis durante el proceso de curación por lo que se consideran verdaderas displasias mesodérmicas, y constituyen un reto para el que las trata, por lo impredecible de su curso y su respuesta caprichosa al tratamiento impuesto. Se presentan en este trabajo 3 pacientes tratadas con cirugía-radiación y en las cuales se han obtenido buenos resultados estéticos y una estabilidad posoperatoria en un promedio de 15 meses de operadas, cuando antes, a los 4 meses, se observaba la reaparición del proceso
Subject(s)
Adolescent , Adult , Humans , Female , Keloid/radiotherapy , Keloid/surgery , Ear, External/radiotherapy , Ear, External/surgeryABSTRACT
Se revisa brevemente el queloide, insistiendo en su patogenia, en el diagnóstico diferencial y en los tratamientos más empleados actualmente. Se señala la utilidad del tratamiento por la radioterapia superficial, presentando la experiencia adquirida en un grupo de 50 pacientes con grupo control