Keloid
☆ Yn 'e 2022 Stiftung Warentest-resultaten út Dútslân wie de konsuminttefredenheid mei ModelDerm mar wat leger dan mei betelle telemedisynkonsultaasjes.
In postoperative keloid op 'e pols dat waard behannele mei triamcinolone intralesional ynjeksje. It sonken erythemgebiet oan 'e linkerkant is it behannele gebiet.
Lineêre Keloïden. As se foarkomme op 'e boppekant fan' e romp, ferskine se faak yn in lineêre foarm.
Posterior auricular Keloid
Keloïden op 'e soallen fan' e fuotten kinne ûngemaklik wêze om op te rinnen. Yntralesionale steroide ynjeksjes wurde meastentiids ferskate kearen útfierd.
Keloïden wurde faak waarnommen op 'e boppeste earms.
Typyske manifestaasje fan boarst keloids.
References
Keloïden foarmje troch ûngewoane genêzing nei hûdblessuere of ûntstekking. Genetyske en omjouwingsfaktoaren drage by oan har ûntwikkeling, mei hegere tariven yn yndividuen mei donkere hûd fan Afrikaanske, Aziatyske en Hispanyske komôf. Keloïden komme foar as fibroblasten oeraktyf wurde, wêrtroch oermjittich kollagen en groeifaktoaren produsearje. Dit liedt ta de formaasje fan grutte, abnormale kollagenbondels bekend as keloidal kollagen, tegearre mei in ferheging fan fibroblasten. Klinysk ferskine keloïden as fêste, rubberige nodules yn gebieten dy't earder ferwûne binne. Oars as normale littekens, keloids útwreidzje bûten de oarspronklike trauma site. Pasjinten kinne ûnderfine pine, jeuk, of brânen. Ferskate behannelingen binne beskikber, ynklusyf steroide-ynjeksjes, kryoterapy, sjirurgy, radiotherapy, en laser-terapy.
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.
It hjoeddeiske ûndersyk suggerearret dat siliconengel of blêden tegearre mei corticosteroid-ynjeksjes de foarkar in earste behanneling is foar keloïden. Oanfoljende behannelingen lykas intralesional 5-fluorouracil (5-FU) , bleomycin, of verapamil kinne ek wurde beskôge, hoewol har effektiviteit ferskilt. Laser-terapy, as kombinearre mei corticosteroid-ynjeksjes of topikale steroïden ûnder occlusion, kin de penetraasje fan medisinen ferbetterje. Foar recalcitrante keloïden hat sjirurgyske ferwidering folge troch direkte bestralingstherapy oantoand effektyf te wêzen. Uteinlik is it brûken fan siliconenblêden en drukterapy bewiisd om de wikseling fan keloïde weromkomst te ferminderjen.
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.
Op it stuit is d'r gjin ien-grutte-past-all-behanneling dy't in konsekwint leech werhellingsnivo garandearret foar keloïden. De groeiende opsjes, lykas it brûken fan lasers neist steroïden of it kombinearjen fan 5-fluorouracil mei steroïden, bewize lykwols belofte. Takomstich ûndersyk kin rjochtsje op hoe goed nije behannelingen, lykas autologe fet grafting of stamsel-basearre terapyen, wurkje foar it behearen fan keloïden.
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.
Scars binne in mienskiplik ûnderdiel fan it genêzingsproses nei hûdblessueres. Ideal moatte littekens flak, tin wêze en passe by de hûdskleur. In protte faktoaren kinne liede ta minne wûne healing, lykas ynfeksje, fermindere bloedstream, ischemia en trauma. Littekens dy't dik, dûnkerder binne as de omlizzende hûd, of oermjittich krimpje kinne wichtige problemen feroarsaakje mei sawol fysike funksje as emosjonele sûnens.
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 wurde faker sjoen yn minsken fan Afrikaanske, Aziatyske of Hispanyske komôf. Minsken tusken de 10 en 30 jier hawwe in hegere oanstriid ta it ûntwikkeljen fan in keloid as âlderen.
Hoewol't se meastal foarkomme op it plak fan in blessuere, keloid kin ek ûntstean spontaan. Se kinne foarkomme op it plak fan in piercing en sels fan wat sa ienfâldich as in pimple of kras. Se kinne foarkomme as gefolch fan slimme akne of wetterpokken littekens, ynfeksje op in wûne site, werhelle trauma oan in gebiet, oermjittige hûd spanning by wound sluten of in frjemd lichem yn in wûne.
Keloïde littekens kinne ûntwikkelje nei operaasje. Se komme faker foar op guon plakken, lykas de sintrale boarst (fan in sternotomy), de rêch en skouders (meastentiids as gefolch fan akne), en de earlellen (fan earpiercings). Se kinne ek foarkomme op lichemspiercings. De meast foarkommende plakken binne earlellen, earms, bekkenregio, en oer de kraachbonke.
Beskikbere behannelingen binne drukterapy, siliconengelblêden, intra-lesionale triamcinoloneacetonide, kryosurgery, strieling, laserterapy, Interferon, 5-FU en sjirurgyske útsûndering.
○ Behanneling
Hypertrofyske littekens kinne ferbetterje mei 5 oant 10 intralesionale steroide-ynjeksjes 1 moanne ynterval.
#Triamcinolone intralesional injection
Laserbehanneling kin besocht wurde foar erythema ferbûn mei littekens, mar triamcinilone-ynjeksjes kinne ek it erytema ferbetterje troch it litteken te platten.
#Dye laser (e.g. V-beam)