Keloid - Keloïed
☆ In die 2022 Stiftung Warentest-resultate van Duitsland was verbruikerstevredenheid met ModelDerm net effens laer as met betaalde telemedisyne-konsultasies.
'n Postoperatiewe keloïed op die pols wat met triamcinolon intralesionale inspuiting behandel is. Die versonke eriteem area aan die linkerkant is die behandelde area.
Lineêre Keloïede. Wanneer hulle op die boonste voorkant van die bolyf voorkom, verskyn hulle dikwels in 'n lineêre vorm.
Posterior aurikulêre Keloid
Keloïede op die voetsole kan ongemaklik wees om op te loop. Intralesionale steroïed-inspuitings word gewoonlik verskeie kere uitgevoer.
Keloïede word algemeen op die bo-arms waargeneem.
Tipiese manifestasie van borskas keloïede.
References
Keloïede vorm as gevolg van ongewone genesing na velbesering of inflammasie. Genetiese en omgewingsfaktore dra by tot hul ontwikkeling, met hoër koerse in donkerder velkleurige individue van Afrika-, Asiatiese en Spaanse afkoms. Keloïede kom voor wanneer fibroblaste ooraktief word, wat oormatige kollageen en groeifaktore produseer. Dit lei tot die vorming van groot, abnormale kollageenbundels bekend as keloïdale kollageen, tesame met 'n toename in fibroblaste. Klinies verskyn keloïede as ferm, rubberagtige nodules in gebiede wat voorheen beseer is. Anders as normale littekens, strek keloïede verder as die oorspronklike trauma-plek. Pasiënte kan pyn, jeuk of brand ervaar. Verskeie behandelings is beskikbaar, insluitend steroïed-inspuitings, krioterapie, chirurgie, radioterapie en laserterapie.
Keloids result from abnormal wound healing in response to skin trauma or inflammation. Keloid development rests on genetic and environmental factors. Higher incidences are seen in darker skinned individuals of African, Asian, and Hispanic descent. Overactive fibroblasts producing high amounts of collagen and growth factors are implicated in the pathogenesis of keloids. As a result, classic histologic findings demonstrate large, abnormal, hyalinized bundles of collagen referred to as keloidal collagen and numerous fibroblasts. Keloids present clinically as firm, rubbery nodules in an area of prior injury to the skin. In contrast to normal or hypertrophic scars, keloidal tissue extends beyond the initial site of trauma. Patients may complain of pain, itching, or burning. Multiple treatment modalities exist although none are uniformly successful. The most common treatments include intralesional or topical steroids, cryotherapy, surgical excision, radiotherapy, and laser therapy.
Keloids result from abnormal wound healing in response to skin trauma or inflammation. Keloid development rests on genetic and environmental factors. Higher incidences are seen in darker skinned individuals of African, Asian, and Hispanic descent. Overactive fibroblasts producing high amounts of collagen and growth factors are implicated in the pathogenesis of keloids. As a result, classic histologic findings demonstrate large, abnormal, hyalinized bundles of collagen referred to as keloidal collagen and numerous fibroblasts. Keloids present clinically as firm, rubbery nodules in an area of prior injury to the skin. In contrast to normal or hypertrophic scars, keloidal tissue extends beyond the initial site of trauma. Patients may complain of pain, itching, or burning. Multiple treatment modalities exist although none are uniformly successful. The most common treatments include intralesional or topical steroids, cryotherapy, surgical excision, radiotherapy, and laser therapy.
Die huidige navorsing dui daarop dat silikoongel of laken saam met kortikosteroïed-inspuitings die voorkeur aanvanklike behandeling vir keloïede is. Bykomende behandelings soos intralesionale 5-fluorouracil (5-FU) , bleomisien of verapamil kan ook oorweeg word, hoewel hul doeltreffendheid verskil. Laserterapie, wanneer dit gekombineer word met kortikosteroïede inspuitings of aktuele steroïede onder afsluiting, kan die penetrasie van dwelms verbeter. Vir weerbarstige keloïede het chirurgiese verwydering gevolg deur onmiddellike bestralingsterapie getoon om effektief te wees. Ten slotte is bewys dat die gebruik van silikoonplate en drukterapie die waarskynlikheid van herhaling van keloïed verminder.
Current literature supports silicone gel or sheeting with corticosteroid injections as first-line therapy for keloids. Adjuvant intralesional 5-fluorouracil (5-FU), bleomycin, or verapamil can be considered, although mixed results have been reported with each. Laser therapy can be used in combination with intralesional corticosteroids or topical steroids with occlusion to improve drug penetration. Excision of keloids with immediate post-excision radiation therapy is an effective option for recalcitrant lesions. Finally, silicone sheeting and pressure therapy have evidence for reducing keloid recurrence.
Current literature supports silicone gel or sheeting with corticosteroid injections as first-line therapy for keloids. Adjuvant intralesional 5-fluorouracil (5-FU), bleomycin, or verapamil can be considered, although mixed results have been reported with each. Laser therapy can be used in combination with intralesional corticosteroids or topical steroids with occlusion to improve drug penetration. Excision of keloids with immediate post-excision radiation therapy is an effective option for recalcitrant lesions. Finally, silicone sheeting and pressure therapy have evidence for reducing keloid recurrence.
Tans is daar geen een-grootte-pas-almal behandeling wat 'n konsekwent lae herhalingsyfer vir keloïede waarborg nie. Die groeiende opsies, soos die gebruik van lasers langs steroïede of die kombinasie van 5-fluorouracil met steroïede, is egter belowend. Toekomstige navorsing kan fokus op hoe goed nuwe behandelings, soos outoloë vetoorplanting of stamsel-gebaseerde terapieë, werk vir die bestuur van keloïede.
There continues to be no gold standard of treatment that provides a consistently low recurrence rate; however the increasing number of available treatments and synergistic combinations of these treatments (i.e., laser-based devices in combination with intralesional steroids, or 5-fluorouracil in combination with steroid therapy) is showing favorable results. Future studies could target the efficacy of novel treatment modalities (i.e., autologous fat grafting or stem cell-based therapies) for keloid management.
There continues to be no gold standard of treatment that provides a consistently low recurrence rate; however the increasing number of available treatments and synergistic combinations of these treatments (i.e., laser-based devices in combination with intralesional steroids, or 5-fluorouracil in combination with steroid therapy) is showing favorable results. Future studies could target the efficacy of novel treatment modalities (i.e., autologous fat grafting or stem cell-based therapies) for keloid management.
Littekens is 'n algemene deel van die genesingsproses na velbeserings. Ideaal gesproke moet littekens plat, dun wees en by die velkleur pas. Baie faktore kan lei tot swak wondgenesing, soos infeksie, verminderde bloedvloei, iskemie en trauma. Littekens wat dik, donkerder as die omliggende vel is, of oormatig krimp, kan beduidende probleme met beide fisiese funksie en emosionele gesondheid veroorsaak.
Scars are a natural and normal part of healing following an injury to the integumentary system. Ideally, scars should be flat, narrow, and color-matched. Several factors can contribute to poor wound healing. These include but are not limited to infection, poor blood flow, ischemia, and trauma. Proliferative, hyperpigmented, or contracted scars can cause serious problems with both function and emotional well-being.
Scars are a natural and normal part of healing following an injury to the integumentary system. Ideally, scars should be flat, narrow, and color-matched. Several factors can contribute to poor wound healing. These include but are not limited to infection, poor blood flow, ischemia, and trauma. Proliferative, hyperpigmented, or contracted scars can cause serious problems with both function and emotional well-being.
Keloïde littekens word meer gereeld gesien by mense van Afrika, Asiatiese of Spaanse afkoms. Mense tussen die ouderdomme van 10 en 30 jaar het 'n groter neiging om 'n keloïed te ontwikkel as bejaardes.
Alhoewel hulle gewoonlik op die plek van 'n besering voorkom, kan keloïed (keloid) ook spontaan ontstaan. Hulle kan voorkom op die plek van 'n piercing en selfs van iets so eenvoudig soos 'n puisie of krap. Hulle kan voorkom as gevolg van ernstige aknee of waterpokkies littekens, infeksie by 'n wondplek, herhaalde trauma aan 'n area, oormatige velspanning tydens wondsluiting of 'n vreemde liggaam in 'n wond.
Keloïed littekens kan na die operasie ontwikkel. Hulle is meer algemeen op sommige plekke, soos die sentrale bors (van 'n sternotomie), die rug en skouers (gewoonlik as gevolg van aknee), en die oorlelle (van oorpiercings). Hulle kan ook op liggaamspierings voorkom. Die mees algemene kolle is oorlelle, arms, bekkengebied en oor die sleutelbeen.
Behandelings wat beskikbaar is, is drukterapie, silikoongelbedekking, intra-letsel-triamcinolonasetonied, kriochirurgie, bestraling, laserterapie, Interferon, 5-FU en chirurgiese uitsnyding.
○ Behandeling
Hipertrofiese littekens kan verbeter met 5 tot 10 intralesionale steroïed inspuitings 1 maand interval.
#Triamcinolone intralesional injection
Laserbehandeling kan probeer word vir eriteem wat met littekens geassosieer word, maar triamciniloon-inspuitings kan ook die eriteem verbeter deur die litteken plat te maak.
#Dye laser (e.g. V-beam)