Keloid
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U rezultatima Stiftung Warentest-a za 2022. iz Njemačke, zadovoljstvo potrošača ModelDerm-om bilo je samo nešto niže nego s plaćenim telemedicinskim konsultacijama.
U rezultatima Stiftung Warentest-a za 2022. iz Njemačke, zadovoljstvo potrošača ModelDerm-om bilo je samo nešto niže nego s plaćenim telemedicinskim konsultacijama.
Postoperativni keloid na zglobu koji je liječen intralezionalnom injekcijom triamcinolona. Područje udubljenja i eritema na lijevoj strani predstavlja tretirano područje.
Linearni keloidi. Kada se pojave na gornjem prednjem dijelu torza, obično su u linearnom obliku.
Zadnji aurikularni keloid
Keloidi na tabanima mogu biti neugodni pri hodanju. Intralezijske injekcije steroida obično se izvode više puta.
Keloidi se najčešće javljaju na nadlakticama.
Tipična manifestacija keloida na grudima.
relevance score : -100.0%
ReferencesKeloidi nastaju zbog abnormalnog zacjeljivanja nakon ozljede ili upale kože. Genetski i okolišni faktori doprinose njihovom razvoju, a učestalost je veća kod osoba tamnije puti afričkog, azijskog i hispanskog porijekla. Keloidi se pojavljuju kada fibroblasti postanu preaktivni i proizvode prekomjerni kolagen i faktore rasta. To dovodi do stvaranja velikih, abnormalnih kolagenskih snopova, poznatih kao keloidni kolagen, uz povećanje broja fibroblasta. Klinički se keloidi manifestuju kao čvrsti, gumeni čvorovi u područjima koja su prethodno bila ozlijeđena. Za razliku od običnih ožiljaka, keloidi se šire izvan granica prvobitne traume. Pacijenti mogu osjetiti bol, svrab ili peckanje. Dostupni su različiti tretmani, uključujući injekcije steroida, krioterapiju, operaciju, radioterapiju i lasersku terapiju.
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.
Trenutna istraživanja sugeriraju da je silikonski gel ili folija, zajedno s injekcijama kortikosteroida, preferirani početni tretman za keloide. Dodatni tretmani, poput intralesionalnog 5‑fluorouracila (5‑FU), bleomicina ili verapamila, također se mogu razmotriti, iako njihova efikasnost varira. Laserska terapija, kada se kombinira s injekcijama kortikosteroida ili lokalnim steroidima pod okluzijom, može poboljšati prodiranje lijekova. Za neodgovarajuće keloide, hirurško uklanjanje, praćeno trenutnom terapijom zračenjem, pokazalo se efikasnim. Konačno, dokazano je da upotreba silikonske folije i presoterapije smanjuje vjerovatnost ponovne pojave keloida.
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.
Trenutno ne postoji jedinstvenog tretmana koji garantuje konstantno nisku stopu recidiva keloida. Međutim, rastuće mogućnosti, poput korištenja lasera uz steroide ili kombiniranja 5‑fluorouracil (5‑fluorouracila) sa steroidima, pokazuju se obećavajućim. Buduća istraživanja mogla bi se fokusirati na to koliko dobro novi tretmani, poput autolognog presađivanja masti ili terapija baziranih na matičnim stanicama, djeluju u upravljanju keloidima.
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.
Ožiljci su čest dio procesa zacjeljivanja nakon ozljeda kože. Idealno, ožiljci bi trebali biti ravni, tanki i u skladu s bojom kože. Na loše zacjeljivanje rana mogu utjecati brojni faktori, poput infekcije, smanjenog protoka krvi, ishemije i traume. Ožiljci koji su debeli, tamniji od okolne kože ili se pretjerano smanjuju mogu uzrokovati značajne probleme, kako u fizičkoj funkciji, tako i u emocionalnom zdravlju.
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.
Keloidni ožiljci se češće javljaju kod osoba afričkog, azijskog ili latinoameričkog porijekla. Osobe u dobi između 10 i 30 godina imaju veću sklonost razvoju keloida od starijih osoba.
Iako se obično pojavljuju na mjestu ozljede, keloidi mogu nastati i spontano. Mogu se pojaviti nakon pirsinga, pa čak i nakon jednostavnih lezija poput bubuljice ili ogrebotine. Također se mogu razviti kao posljedica teških ožiljaka od akni ili vodenih kozica, infekcije na mjestu rane, ponovljenih trauma, prekomjerne napetosti kože tijekom zatvaranja rane ili prisutnosti stranog tijela u rani.
Keloidni ožiljci se mogu razviti nakon operacije. Najčešći su na mjestima kao što su središnji dio grudnog koša (sternotomija), leđa i ramena (često posljedica akni) te ušne školjke (pirsing uha). Mogu se pojaviti i na drugim mjestima pirsinga na tijelu. Najčešće zahvaćene su ušne resice, ruke, karlični region i područje iznad ključne kosti.
Dostupni tretmani uključuju terapiju tlakom, oblaganje silikonskim gelom, triamcinolon acetonid unutar lezije, kriohirurgiju, zračenje, lasersku terapiju, interferon, 5‑FU i hiruršku eksciziju.
○ Tretman
Hipertrofični ožiljci mogu se poboljšati 5‑do 10 intralesionalnih injekcija steroida u intervalu od 1 mjeseca.
#Triamcinolone intralesional injection
Lasersko liječenje može se isprobati za eritem povezan s ožiljcima, a injekcije triamcinolona također mogu smanjiti eritem izravnavanjem ožiljka.
#Dye laser (e.g. V‑beam)