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KELOIDS AND HYPERTROPHIC SCARS

Keloids and hypertrophic scars are abnormalities in the normal wound healing characterized by greater and more sustained extracellular matrix deposition that develops after any insult in the dermis.

It can affect the patient's quality of life, both physically and psychologically.

Hypertrophic scars are raised fibrous tissue scars that remains within the boundaries of the wound. Hypertrophic scars that resulted from surgery or trauma are called linear hypertrophic scars while those from burn injuries or extensive tissue trauma and/or infections are called widespread hypertrophic scars.

Keloids are elevated fibrous scars that extend beyond the borders of the original wound. Major keloids resulted from minor trauma while for those from genetic predisposition with autosomal-predominant features are called minor keloids.

 

 

Radiotherapy

  • Post-excisional electron beam irradiation or brachytherapy (using Iridium-192) are alternative treatment options for adult patients w/ keloids or hypertrophic scars at high risk for recurrence
  • Inhibits new cell proliferation by mitosis-induced cell death or altering mitosis; also possesses antiinflammatory effects by inducing lymphocyte apoptosis, fibroblast differentiation, leukocyte & oligonucleotide adhesion
  • Should be done w/ proper coordination w/ an experienced radiation oncologist to decrease risk of unwanted adverse events (eg hyperpigmentation, atrophy, carcinogenesis)
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