Keloid
☆ An den 2022 Stiftung Warentest Resultater aus Däitschland war d'Zefriddenheet vum Konsument mam ModelDerm nëmme liicht manner wéi mat bezuelte Telemedizin Konsultatiounen.
E postoperative Keloid um Handgelenk deen mat Triamcinolone intralesional Injektioun behandelt gouf. D'gesonkt Erythema Beräich op der lénker Säit ass dat behandelt Gebitt.
Linear Keloid. Wann se op der ieweschter Front vum Torso optrieden, schéngen se dacks an enger linearer Form.
Posterior auricular Keloid
Keloid op de Féiss kann onwuel zu Fouss.Intralesional Steroid Injektiounen ginn normalerweis e puer Mol gemaach.
Keloiden ginn allgemeng op den Uewerarm beobachtet.
Typesch Manifestatioun vun Këscht keloids.
References
Keloiden bilden sech wéinst ongewéinlecher Heelung no Hautverletzung oder Entzündung. Genetesch an ëmweltfrëndlech Faktoren droen zu hirer Entwécklung bäi, mat méi héijen Tariffer an däischter Haut Individuen vun afrikaneschen, asiateschen a spueneschen Ofstamung. Keloiden geschéien wann Fibroblasten iwweraktiv ginn, exzessiv Kollagen a Wuesstumsfaktoren produzéieren. Dëst féiert zu der Bildung vu groussen, anormale Kollagenbündelen bekannt als keloidal Kollagen, zesumme mat enger Erhéijung vun de Fibroblasten. Klinesch erschéngen d'Keloiden als fest, gummiknäppeg Knollen a Gebidder, déi virdru blesséiert goufen. Am Géigesaz zu normale Narben verlängeren d'Keloiden iwwer déi ursprénglech Traumaplaz. Patienten kënnen Péng, Jucken oder Brennen erliewen. Verschidde Behandlunge si verfügbar, dorënner Steroidinjektiounen, Kryotherapie, Chirurgie, Radiotherapie a Lasertherapie.
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.
Déi aktuell Fuerschung suggeréiert datt Silikongel oder Blat zesumme mat Kortikosteroidinjektiounen déi bevorzugt initial Behandlung fir Keloiden ass. Zousätzlech Behandlungen wéi intralesional 5-Fluorouracil (5-FU) , Bleomycin oder Verapamil kënnen och berücksichtegt ginn, obwuel hir Effektivitéit variéiert. Laser Therapie, wann kombinéiert mat Corticosteroid Injektiounen oder topesch Steroiden ënner Okklusioun, kann d'Penetratioun vun Drogen verbesseren. Fir recalcitrant Keloiden, chirurgesch Entfernung gefollegt vun direkter Strahlungstherapie huet effektiv gewisen. Schlussendlech ass d'Benotzung vu Silikonplacken an Drocktherapie bewisen datt d'Wahrscheinlechkeet vum Keloide Widderhuelung reduzéiert gëtt.
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.
De Moment gëtt et keng eent-Gréisst-passt-all Behandlung déi e konsequent nidderegen Widderhuelungsquote fir Keloiden garantéiert. Wéi och ëmmer, déi wuessend Optiounen, wéi d'Benotzung vu Laser niewent Steroiden oder d'Kombinatioun vun 5-Fluorouracil mat Steroiden, beweisen villverspriechend. Zukünfteg Fuerschung kéint konzentréieren op wéi gutt nei Behandlungen, wéi autolog Fetttransplantatioun oder Stammzell-baséiert Therapien, fir d'Gestioun vun Keloiden funktionnéieren.
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.
Narben sinn e gemeinsame Bestanddeel vum Heelprozess no Hautverletzungen. Idealerweis sollten Narben flaach, dënn sinn a mat der Hautfaarf passen. Vill Faktoren kënnen zu enger schlechter Woundheilung féieren, wéi Infektioun, reduzéiert Bluttfluss, Ischämie an Trauma. Narben déi déck, méi däischter sinn wéi d'Haut ronderëm, oder exzessiv schrumpfen, kënne bedeitend Problemer mat der kierperlecher Funktioun an der emotionaler Gesondheet verursaachen.
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.
Keloid Narben ginn méi dacks bei Leit vun afrikaneschen, asiateschen oder spueneschen Ofstamung gesi. Leit tëscht 10 an 30 Joer hunn eng méi héich Tendenz fir e Keloid z'entwéckelen wéi eeler.
Obwuel si normalerweis op der Plaz vun enger Verletzung geschéien, keloid kann och spontan entstoen. Si kënnen op der Plaz vun engem Piercing optrieden a souguer vun eppes sou einfach wéi e Pickel oder Schrummen. Si kënnen optrieden als Resultat vu schwéieren Akne oder Waasserpocken Narben, Infektioun op enger Woundplaz, widderholl Trauma zu engem Gebitt, exzessive Hautspannung während der Woundverschluss oder engem auslännesche Kierper an enger Wonn.
Keloid Narben kënnen no der Operatioun entwéckelen. Si si méi heefeg op e puer Siten, wéi zum Beispill d'Zentralkëscht (vun enger Sternotomie), de Réck a Schëlleren (normalerweis entstinn aus Akne), an d'Ouerloben (vu Ouerpiercings). Si kënnen och op Kierperpiercings optrieden. Déi heefegste Flecken sinn Ouerréng, Waffen, Beckenregioun, an iwwer de Halsband.
Verfügbar Behandlungen sinn Drocktherapie, Silikongelplack, intra-lesional Triamcinolone Acetonid, Kryochirurgie, Stralung, Lasertherapie, Interferon, 5-FU a chirurgesch Ausschnëtter.
○ Behandlung
Hypertrophesch Narben kënne mat 5 bis 10 intralesional Steroidinjektiounen 1 Mount Intervall verbesseren.
#Triamcinolone intralesional injection
Laserbehandlung kann probéiert ginn fir Erythema verbonne mat Narbenbildung, awer Triamcinilone Injektiounen kënnen och d'Erythema verbesseren andeems d'Narben ofplatt ginn.
#Dye laser (e.g. V-beam)