Keloid
☆ Ann an toraidhean 2022 Stiftung Warentest às a’ Ghearmailt, cha robh sàsachd luchd-cleachdaidh le ModelDerm ach beagan nas ìsle na le co-chomhairlean telemedicine pàighte.
keloid postoperative air an dùirn a chaidh a làimhseachadh le in-stealladh intralesional triamcinolone. Is e an raon erythema fodha air an taobh chlì an raon làimhseachaidh.
Linear Keloids. Nuair a bhios iad a ‘tachairt air aghaidh àrd an torso, bidh iad gu tric a’ nochdadh ann an cruth sreathach.
Posterior auricular Keloid
Faodaidh Keloids air buinn nan casan a bhith mì-chofhurtail coiseachd air. Mar as trice bidh in-stealladh steroid intralesional air a dhèanamh grunn thursan.
Tha Keloids gu tric rim faicinn air na gàirdeanan àrda.
Taisbeanadh àbhaisteach de keloids broilleach.
References
Bidh keloids a’ cruthachadh mar thoradh air slànachadh neo-àbhaisteach às deidh dochann craiceann no sèid. Bidh factaran ginteil agus àrainneachd a’ cur ri an leasachadh, le ìrean nas àirde ann an daoine le craiceann nas dorcha de shliochd Afraganach, Àisianach agus Hispanic. Bidh Keloids a’ tachairt nuair a dh’ fhàsas fibroblasts ro-ghnìomhach, a’ toirt a-mach cus collagen agus factaran fàis. Bidh seo a’ leantainn gu cruthachadh phasganan collagen mòr, neo-àbhaisteach ris an canar collagen keloidal, còmhla ri àrdachadh ann am fibroblasts. Gu clionaigeach, tha keloids a 'nochdadh mar nodules làidir, rubair ann an ceàrnaidhean a chaidh a leòn roimhe. Eu-coltach ri sgaraidhean àbhaisteach, tha keloids a 'leudachadh nas fhaide na an làrach trauma tùsail. Faodaidh euslaintich pian, itching, no losgadh fhaighinn. Tha diofar leigheasan rim faighinn, a’ gabhail a-steach in-stealladh steroid, cryotherapy, lannsaireachd, radiotherapy, agus leigheas laser.
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.
Tha an rannsachadh gnàthach a’ moladh gur e gel silicone no siotaichean còmhla ri in-stealladh corticosteroid an làimhseachadh tùsail as fheàrr leotha airson keloids. Faodar beachdachadh cuideachd air leigheasan a bharrachd leithid 5-fluorouracil intralesional (5-FU) , bleomycin, no verapamil, ged a tha an èifeachdas ag atharrachadh. Faodaidh leigheas laser, nuair a thèid a chur còmhla ri in-stealladh corticosteroid no steroids gnàthach fo occlusion, cur ri dol a-steach dhrogaichean. Airson keloids recalcitrant, tha toirt air falbh lannsa air a leantainn le leigheas rèididheachd sa bhad air dearbhadh gu bheil e èifeachdach. Mu dheireadh, thathas air dearbhadh gu bheil cleachdadh còmhdach silicone agus leigheas cuideam a ’lughdachadh an coltas gum bi keloid a’ tachairt a-rithist.
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.
An-dràsta, chan eil làimhseachadh aon-mheud ann a tha a’ gealltainn ìre ath-chuairteachaidh cunbhalach ìosal airson keloids. Ach, tha na roghainnean a tha a’ fàs, leithid a bhith a’ cleachdadh lasers còmhla ri steroids no a’ cothlamadh 5-fluorouracil le steroids, gealltanach. Dh'fhaodadh rannsachadh san àm ri teachd fòcas a chuir air dè cho math 'sa tha leigheasan ùra, leithid grafadh geir fèin-fhillte no leigheasan stèidhichte air bun-cheallan, ag obair airson a bhith a' stiùireadh keloids.
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.
Tha sgarfaichean mar phàirt cumanta den phròiseas slànachaidh às deidh leòn craiceann. Gu h-iomchaidh, bu chòir sgarfaichean a bhith còmhnard, tana, agus a 'maidseadh dath a' chraicinn. Faodaidh mòran fhactaran leantainn gu droch shlànachadh lotan, leithid gabhaltachd, sruth fala nas lugha, ischemia, agus trauma. Faodaidh sgarfaichean a tha tiugh, nas dorcha na an craiceann mun cuairt orra, no a tha a’ crìonadh cus, duilgheadasan mòra adhbhrachadh le gnìomhachd corporra agus slàinte thòcail.
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.
Tha sgaraidhean keloid rim faicinn nas trice ann an daoine de shliochd Afraganach, Àisianach no Hispanic. Tha daoine eadar aois 10 agus 30 bliadhna nas buailtiche keloid a leasachadh na seann daoine.
Ged a bhios iad mar as trice a 'tachairt aig làrach leòn, faodaidh keloid èirigh gu neo-eisimeileach cuideachd. Faodaidh iad tachairt aig làrach tolladh agus eadhon bho rudeigin cho sìmplidh ri pimple no sgrìob. Faodaidh iad tachairt mar thoradh air fìor dhroch acne no sgrìobadh de bhreac na cearc, galar aig làrach leòn, trauma a-rithist gu sgìre, cus teannachadh craiceann nuair a dhùin an lot no corp cèin ann an lot.
Faodaidh sgaraidhean keloid leasachadh às deidh lannsaireachd. Tha iad nas cumanta ann an cuid de làraich, leithid a 'chiste sa mheadhan (bho sternotomy), an cùl agus na guailnean (mar as trice mar thoradh air acne), agus na lobes cluaise (bho tholladh cluaise). Faodaidh iad cuideachd tachairt air tolladh bodhaig. Is e na spotan as cumanta cluaisean, gàirdeanan, roinn pelvic, agus thairis air cnàimh nan collar.
Is e na leigheasan a tha rim faighinn leigheas cuideam, còmhdach gel silicone, acetonide triamcinolone taobh a-staigh lesional, cryosurgery, rèididheachd, laser therapy, Interferon, 5-FU agus excision lannsa.
○ làimhseachadh
Faodaidh sgaraidhean hypertrophic leasachadh le 5 gu 10 in-stealladh steroid intralesional eadar 1 mìos.
#Triamcinolone intralesional injection
Faodar làimhseachadh laser fheuchainn airson erythema co-cheangailte ri sgrìobadh, ach faodaidh in-stealladh triamcinilone an erythema a leasachadh le bhith a’ rèidh a’ scar.
#Dye laser (e.g. V-beam)