Keloid
☆ Di encamên 2022-an de Stiftung Warentest ji Almanyayê, razîbûna xerîdar bi ModelDerm tenê ji şêwirmendên telemedicine drav hindik hindiktir bû.
Keloîdek piştî emeliyatê li ser destikê ku bi derziya hundurîn a triamcinolone hate derman kirin. Qada erythema ya binavbûyî ya li milê çepê qada dermankirî ye.
Keloids Linear. Gava ku ew li eniya jorîn a torso çêdibin, ew pir caran bi rengek xêzik xuya dibin.
Keloid auricular paş
Keloids li ser lingên lingan dibe ku nerehetî li ser rêve. Derziyên steroîdan intralesional bi gelemperî çend caran têne kirin.
Keloids bi gelemperî li ser milên jorîn têne dîtin.
Nîşana tîpîk a keloîdên sîngê.
References
Keloîd ji ber başbûna neasayî piştî birîn an iltîhaba çerm çêdibin. Faktorên genetîkî û hawîrdorê beşdarî pêşkeftina wan dibin, bi rêjeyên bilindtir di kesên çermê tarî yên bi eslê xwe Afrîkî, Asyayî û Hispanîkî de. Keloids çêdibe dema ku fibroblast zêde çalak dibin, kolajen û faktorên mezinbûnê yên zêde hilberînin. Ev dibe sedema çêbûna girseyên mezin, anormal ên kolajenê ku wekî kolajena keloidal têne zanîn, ligel zêdebûna fibroblastan. Ji hêla klînîkî ve, keloîd li deverên ku berê birîndar bûne wekî nodulên hişk û gomî xuya dikin. Berevajî birînên normal, keloîd ji cîhê trawmaya orjînal derbas dibin. Nexweş dibe ku êş, xurîn, an şewitandinê bibînin. Tedawiyên cûrbecûr hene, di nav de derziyên steroîdan, kryoterapî, emeliyat, radyoterapî, û terapiya lazer.
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.
Lêkolîna heyî destnîşan dike ku jelê silicone an pelika li gel derziyên kortikosteroid dermankirina destpêkê ya bijartî ya keloîd e. Tedawiyên din ên mîna 5-fluorouracil (5-FU) , bleomycin, an verapamil jî dikarin bêne hesibandin, her çend bandoriya wan cûda dibe. Terapiya lazerê, dema ku bi derziyên kortikosteroîd an steroîdên topkî yên di bin dorpêçê de were hevber kirin, dikare ketina dermanan zêde bike. Ji bo keloîdên nerazî, rakirina neştergerî ya ku bi terapiya tîrêjê ya tavilê tê şopandin bandorker e. Di dawiyê de, bi karanîna pelika silicone û terapiya zextê hate îsbat kirin ku îhtîmala dûbarebûna keloîd kêm dike.
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.
Heya nuha, tedawiyek yek-salî tune ku ji bo keloids rêjeyek dûbarebûna domdar kêm garantî dike. Lêbelê, vebijarkên mezinbûnê, mîna karanîna lazeran ligel steroîdan an berhevkirina 5-fluorouracil bi steroîdan re, sozdar in. Lêkolîna pêşeroj dikare balê bikişîne ser ka çawa dermankirinên nû, wek girtina rûnê xweser an dermankirinên bingehîn ên hucreyên stem, ji bo birêvebirina keloîdê çiqas baş dixebitin.
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.
Birîn beşek hevpar a pêvajoya başbûnê ya piştî birînên çerm in. Bi îdeal, birîn divê birûskê, zirav, û bi rengê çermê re hevaheng bin. Gelek faktor dikarin bibin sedema başbûna birînên nebaş, wek enfeksiyon, kêmbûna herikîna xwînê, iskemî û trawma. Birînên ku ji çermê derdorê stûrtir, tarîtir in, an jî pir piçûk dibin dikarin hem di fonksiyona laşî û hem jî di tenduristiya hestyarî de bibin sedema pirsgirêkên girîng.
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.
Birînên keloîd di mirovên bi eslê xwe Afrîkî, Asyayî, an Hispanîkî de pir caran têne dîtin. Kesên di navbera 10 û 30 salî de ji kal û pîran meyla pêşkeftina keloidê zêdetir in.
Her çend ew bi gelemperî li cîhê birînek çêdibin, keloid jî dikare bi xweber çêbibe. Ew dikarin li cîhê qulandinê û hetta ji tiştek sade wekî pizrik an qulikê çêbibin. Ew dikarin wekî encama pizrikek giran an şopa pizrika mirîşkan, enfeksiyona li cîhek birînê, travmaya dubare ya li deverek, tansiyona zêde ya çerm di dema girtina birînê de an laşek biyanî di birînekê de çêbibin.
Birînên keloîd dikarin piştî emeliyatê çêbibin. Ew li hin deveran pirtir in, wek sînga navendî (ji sternotomî), pişt û mil (bi gelemperî ji pizrikan çêdibin), û lobên guh (ji qulkirina guh). Ew dikarin li ser qulên laş jî çêbibin. Xalên herî berbelav guh, dest, herêma pelvîk û li ser hestiyê stûyê ne.
Dermankirinên berdest tedawiya zextê, pelika gêla silîkonê, acetonide triamcinolone intra-lezional, cryosurgery, radyasyon, terapiya lazer, Interferon, 5-FU û derxistina neştergerî ne.
○ Demankirinî
Birînên hîpertrofîk dikarin bi 5 heta 10 derziyên steroîdan ên hundurîn ên navberê 1 meh çêtir bibin.
#Triamcinolone intralesional injection
Dibe ku tedawiya lazerê ji bo erythema ku bi birînbûnê ve girêdayî ye were ceribandin, lê derziyên triamcinilone jî dikarin erythema bi xêzkirina şopê baştir bikin.
#Dye laser (e.g. V-beam)