Factors associated with postpiercing auricular cartilage keloids

To determine the factors responsible for postpiercing auricular cartilage keloids. Observational study. Department of Plastic Surgery, King Edward Medical University [KEMU], Lahore, from March 2007 to July 2010. Fifty patients of post-earpiercing keloids affecting the cartilaginous portion were included in the study. Patients with keloids at any other site, positive family history of keloids and recurrent keloids were excluded. Information regarding age at piercing, site of piercing, use of gun or home sewing needle for piercing, use of jewellery other than gold postpiercing, itching or redness with use of jewellery, tight fitting of jewellery in the piercing hole and postpiercing infection was collected. Fisher exact and Wilcoxon rank sum tests were used to analyse the data. All the patients had low lobule piercing at a mean age of 4.52 +/- 1.15 years and cartilage piercing at an average age of 22.32 +/- 3.74 years [p < 0.001]. Eleven patients [22%] had also simultaneous high piercing in the lobule. Only cartilage piercing sites developed the keloids. Postpiercing infection was present in all the 50 patients of cartilage piercing whereas only 3 out of 11 high lobule piercing sites got infected [p < 0.001]. Cartilage bearing portion of the ear is more likely to form keloids due to its piercing in or after adolescence and prolonged wound healing caused by infection