Risk factors associated with the progression from keloids to severe keloids / 中华医学杂志(英文版)

BACKGROUND@#Keloids are benign fibrous growths that are caused by excessive tissue build-up. Severe keloids exert more significant effects on patients' quality of life than do mild keloids. We aimed to identify factors associated with the progression from mild keloids to severe keloids, as distinct from those associated with the formation of keloids.@*METHODS@#In this retrospective case-control study, 251 patients diagnosed with keloids at West China Hospital between November 2018 and April 2021 were grouped according to the severity of lesions (mild [n = 162] or severe [n = 89]). We collected their basic characteristics, living habits, incomes, comorbidities, and keloid characteristics from Electronic Medical Records in the hospital and the patients' interviews. Conditional multivariable regression was performed to identify the independent risk factors for the progression of keloids.@*RESULTS@#Eighty-nine patients (35.5%) were classified as having severe keloids. We found the distribution of severe keloids varied with sex, age, excessive scrubbing of keloids, family income, the comorbidity of rheumatism, disease duration, characteristics of the location, location in sites of high-stretch tension, the severity and frequency of pain, the severity of pruritus, and infection. Multivariable analysis revealed significant associations between severe keloids and infection (odds ratio [OR], 3.55; P = 0.005), excessive scrubbing of keloids (OR, 8.65; P = 0.001), low or middle family income (OR, 13.44; P = 0.021), comorbidity of rheumatism (OR, 18.97; P = 0.021), multiple keloids located at multiple sites (OR, 3.18; P = 0.033), and disease duration > 15 years (OR, 2.98; P = 0.046).@*CONCLUSION@#Doctors should implement more active and thorough measures to minimize the progression of mild keloids in patients who have any of the following risk factors: infection, excessive scrubbing of keloids, low or middle family income, comorbidity of rheumatism, multiple keloids located at multiple sites, and disease duration > 15 years.

Queloides y cicatrices hipertróficas: problema frecuente de manejo complejo / Keloids and hypertrophic scars: frequent problem of complex management

Keloids and hypertrophic scars are frequent observed. These two conditions are considered part of the abnormal wound-healing spectrum. The main difference between keloids and hypertrophic scars is the scar extension in relation to the original incision, where former extends beyond the original incision while the latter respects it. The main issue with both conditions is that treatment modalities used today offer unacceptable high recurrence rates, between 50 to 70 percent, when they are applied as monotherapy. With combined treatment modalities recurrence rates have improved partially depending mainly in the chosen combination and so, this strategy is likely the optimal choice for the management of these lesions. The objective of this review was to highlight the pathophysiology, clinical features, and management of keloids with mono or combined therapy, focusing mainly in the surgical and radiotherapy/brachytherapy modalities.

Quelóides e cicatrizes hipertróficas: ensaio terapêutico / Keloids and hypertrophic scars: therapeutic trial

Quelóides e cicatrizes hipertróficas representam importante problema dermatológico e temidas complicações de procedimentos cirúrgicos. Com raras exceções, tentativas profiláticas e terapêuticas para controle desses distúrbios tem sido de sucesso limitado...No final do ensaio, verificou-se que a colchicina reduziu a consistência de 91,3% e o volume de 56,5% das lesões tratadas, observando-se percentuais correspondentes de 89,3 e 46,4 com a pentoxifilina. Um caso de eczematização local e um caso de prurido generalizado, moderados, possivelmente provocados pela colchicina, constituíram os únicos efeitos adversos registrados.