Keloid
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Keloid selepas pembedahan pada pergelangan tangan yang dirawat dengan suntikan intralesi triamcinolone. Kawasan eritema yang tenggelam di sebelah kiri adalah kawasan yang dirawat.
Keloid Linear. Apabila ia berlaku di bahagian atas bahagian atas badan, ia sering muncul dalam bentuk linear.
Keloid aurikular posterior
Keloid pada tapak kaki boleh menjadi tidak selesa untuk berjalan. Suntikan steroid intralesi biasanya dilakukan beberapa kali.
Keloid biasanya diperhatikan pada bahagian atas lengan.
Manifestasi biasa keloid dada.
relevance score : -100.0%
ReferencesKeloid terbentuk kerana proses penyembuhan yang berlebihan selepas kecederaan atau keradangan kulit. Faktor genetik dan persekitaran menyumbang kepada perkembangannya, dengan kadar yang lebih tinggi dalam individu berkulit gelap keturunan Afrika, Asia, dan Hispanik. Keloid berlaku apabila fibroblas menjadi terlalu aktif, menghasilkan kolagen dan faktor pertumbuhan secara berlebihan. Ini menyebabkan pembentukan serat kolagen yang besar dan tidak normal, dikenali sebagai kolagen keloid, serta peningkatan bilangan fibroblas. Secara klinikal, keloid kelihatan sebagai nodul bergetah padat pada kawasan yang pernah cedera. Tidak seperti parut biasa, keloid melampaui batas tapak trauma asal. Pesakit mungkin mengalami sakit, gatal, atau rasa terbakar. Pelbagai rawatan tersedia, termasuk suntikan steroid, krioterapi, pembedahan, radioterapi, dan terapi 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.
Penyelidikan terkini mencadangkan bahawa gel silikon atau cadar bersama suntikan kortikosteroid merupakan rawatan awal pilihan untuk keloid. Rawatan tambahan seperti intralesi 5-fluorouracil (5-FU), bleomycin, atau verapamil juga boleh dipertimbangkan, walaupun keberkesanannya berbeza‑beza. Terapi laser, apabila digabungkan dengan suntikan kortikosteroid atau steroid topikal di bawah oklusi, dapat meningkatkan penembusan ubat. Bagi keloid keras, pembuangan pembedahan diikuti dengan terapi sinaran segera telah terbukti berkesan. Akhir sekali, penggunaan lapisan silikon dan terapi tekanan telah terbukti mengurangkan risiko keloid berulang.
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.
Pada masa ini, tiada satu rawatan yang sesuai untuk semua yang dapat menjamin kadar berulang keloid yang rendah secara konsisten. Walau bagaimanapun, pilihan yang semakin meningkat, seperti penggunaan laser bersama steroid atau gabungan 5-fluorouracil dengan steroid, telah terbukti menjanjikan. Penyelidikan masa depan boleh memberi tumpuan kepada sejauh mana rawatan baharu, seperti cantuman lemak autologous atau terapi berasaskan sel stem, berkesan dalam menguruskan keloid.
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.
Parut merupakan bahagian biasa dalam proses penyembuhan selepas kecederaan kulit. Sebaik‑baiknya, parut hendaklah rata, nipis, dan sepadan dengan warna kulit. Pelbagai faktor boleh menyebabkan penyembuhan luka yang lemah, seperti jangkitan, pengurangan aliran darah, iskemia, dan trauma. Parut yang tebal, lebih gelap daripada kulit sekeliling, atau mengecut secara berlebihan boleh menimbulkan masalah ketara pada fungsi fizikal dan kesihatan emosi.
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.
Parut keloid lebih kerap ditemui pada individu berketurunan Afrika, Asia, atau Hispanik. Orang berumur antara 10 dan 30 tahun mempunyai risiko lebih tinggi untuk mengembangkan keloid berbanding orang yang lebih tua.
Walaupun biasanya muncul pada tapak kecederaan, keloid juga boleh timbul secara spontan. Ia boleh muncul pada tapak menindik serta pada lesi yang mudah seperti jerawat atau calar. Keloid juga boleh terbentuk akibat jerawat teruk, parut cacar air, jangkitan pada tapak luka, trauma berulang, ketegangan kulit yang berlebihan semasa penutupan luka, atau kehadiran badan asing dalam luka.
Parut keloid boleh muncul selepas pembedahan. Ia lebih biasa pada beberapa lokasi, seperti dada tengah (selepas sternotomi), belakang dan bahu (biasanya disebabkan oleh jerawat), serta cuping telinga (selepas tindikan telinga). Ia juga boleh berlaku pada tindikan badan. Tempat yang paling kerap terlibat ialah cuping telinga, lengan, kawasan pelvis, dan atas tulang selangka.
Rawatan yang tersedia termasuk terapi tekanan, pelapisan gel silikon, triamcinolone acetonide intralesi, cryosurgery, sinaran, terapi laser, Interferon, 5‑FU, dan pembedahan pengasingan.
○ Rawatan
Parut hipertropik boleh bertambah baik dengan 5 hingga 10 suntikan steroid intralesi dalam selang masa 1 bulan.
#Triamcinolone intralesional injection
Rawatan laser boleh dicuba untuk eritema yang berkaitan dengan parut, tetapi suntikan triamcinilone juga boleh memperbaiki eritema dengan meratakan parut.
#Dye laser (e.g. V-beam)