Keloid
☆ Fir-riżultati ta' Stiftung Warentest tal-2022 mill-Ġermanja, is-sodisfazzjon tal-konsumatur b'ModelDerm kien biss ftit inqas milli b'konsultazzjonijiet bit-telemediċina mħallsa.
Kelojde ta 'wara l-operazzjoni fuq il-polz li ġie ttrattat b'injezzjoni intrależjonali ta' triamcinolone. Iż-żona eritema mgħaddsa fuq in-naħa tax-xellug hija ż-żona ttrattata.
Keloids Lineari. Meta jseħħu fuq in-naħa ta 'fuq tat-torso, ħafna drabi jidhru f'forma lineari.
Keloid awrikali ta' wara
Keloids fuq il-qigħan tas-saqajn jistgħu jkunu skomdi biex jimxu fuq.
Keloids huma komunement osservati fuq id-dirgħajn.
Manifestazzjoni tipika ta 'keloids tas-sider.
References
Keloids jiffurmaw minħabba fejqan mhux tas-soltu wara korriment fil-ġilda jew infjammazzjoni. Fatturi ġenetiċi u ambjentali jikkontribwixxu għall-iżvilupp tagħhom, b'rati ogħla f'individwi ta 'ġilda aktar skura ta' dixxendenza Afrikana, Ażjatika u Hispanika. Il-kelojdi jseħħu meta l-fibroblasti jsiru attivi żżejjed, u jipproduċu kollaġen eċċessiv u fatturi ta 'tkabbir. Dan iwassal għall-formazzjoni ta 'qatet kbar ta' kollaġen mhux normali magħrufa bħala kollaġen keloidal, flimkien ma 'żieda fil-fibroblasti. Klinikament, keloids jidhru bħala noduli sodi, tal-gomma f'żoni li qabel kienu midruba. B'differenza ċikatriċi normali, keloids jestendu lil hinn mis-sit oriġinali tat-trawma. Il-pazjenti jistgħu jesperjenzaw uġigħ, ħakk jew ħruq. Diversi trattamenti huma disponibbli, inklużi injezzjonijiet ta 'sterojdi, krijoterapija, kirurġija, radjuterapija, u terapija bil-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.
Ir-riċerka attwali tissuġġerixxi li ġel tas-silikonju jew folji flimkien ma 'injezzjonijiet ta' kortikosterojdi huwa t-trattament inizjali preferut għall-kelojdi. Jistgħu jitqiesu wkoll trattamenti addizzjonali bħal 5-fluorouracil intrależjonali (5-FU) , bleomycin, jew verapamil, għalkemm l-effettività tagħhom tvarja. It-terapija bil-lejżer, meta kkombinata ma 'injezzjonijiet ta' kortikosterojdi jew sterojdi topiċi taħt okklużjoni, tista 'ssaħħaħ il-penetrazzjoni tad-drogi. Għal keloids rekalċitranti, it-tneħħija kirurġika segwita minn terapija ta 'radjazzjoni immedjata wriet li hija effettiva. Fl-aħħarnett, l-użu ta 'folji tas-silikon u terapija tal-pressjoni ġie ppruvat li jnaqqas il-probabbiltà ta' rikorrenza tal-kelojdi.
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.
Bħalissa, m'hemm l-ebda trattament ta 'daqs wieħed li jiggarantixxi rata ta' rikorrenza konsistentement baxxa għal keloids. Madankollu, l-għażliet li qed jikbru, bħall-użu tal-lejżers flimkien ma 'sterojdi jew il-kombinazzjoni ta' 5-fluorouracil ma 'sterojdi, qed juru promettenti. Ir-riċerka futura tista' tiffoka fuq kemm trattamenti ġodda, bħat-tilqim ta' xaħam awtologu jew terapiji bbażati fuq iċ-ċelloli staminali, jaħdmu għall-ġestjoni tal-kelojdi.
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.
Iċ-ċikatriċi huma parti komuni mill-proċess ta 'fejqan wara korrimenti fil-ġilda. Idealment, iċ-ċikatriċi għandhom ikunu ċatti, irqaq, u jaqblu mal-kulur tal-ġilda. Ħafna fatturi jistgħu jwasslu għal fejqan ħażin tal-feriti, bħal infezzjoni, tnaqqis fil-fluss tad-demm, iskemija, u trawma. Ċikatriċi li huma ħoxnin, jiskuraw mill-ġilda tal-madwar, jew jiċkienu eċċessivament jistgħu jikkawżaw kwistjonijiet sinifikanti kemm mal-funzjoni fiżika kif ukoll mas-saħħa emozzjonali.
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.
Iċ-ċikatriċi keloid jidhru aktar ta 'spiss f'nies ta' dixxendenza Afrikana, Ażjatika jew Ispanika. Nies bejn l-10 u t-30 sena għandhom tendenza ogħla li jiżviluppaw keloid mill-anzjani.
Għalkemm normalment iseħħu fis-sit ta 'korriment, keloid jistgħu wkoll jinqalgħu spontanjament. Jistgħu jseħħu fis-sit ta 'titqib u anke minn xi ħaġa sempliċi bħal pimple jew scratch. Jistgħu jseħħu bħala riżultat ta 'akne severa jew ċikatriċi tar-riħ, infezzjoni f'sit tal-ferita, trawma ripetuta f'żona, tensjoni eċċessiva tal-ġilda waqt l-għeluq tal-ferita jew korp barrani f'ferita.
Ċikatriċi keloid jistgħu jiżviluppaw wara l-kirurġija. Huma aktar komuni f'xi siti, bħas-sider ċentrali (minn sternotomija), id-dahar u l-ispallejn (ġeneralment jirriżultaw mill-akne), u l-lobi tal-widnejn (minn titqib tal-widnejn). Jistgħu jseħħu wkoll fuq titqib tal-ġisem. L-iktar spots komuni huma l-lobi tal-widnejn, id-dirgħajn, ir-reġjun pelviku, u fuq l-għadam tal-għonq.
It-trattamenti disponibbli huma terapija bil-pressjoni, folji tal-ġel tas-silikonju, triamcinolone acetonide intra-leżjonali, krijokirurġija, radjazzjoni, terapija bil-lejżer, Interferon, 5-FU u qtugħ kirurġiku.
○ Trattament
Ċikatriċi ipertrofiċi jistgħu jitjiebu b'5 sa 10 injezzjonijiet ta 'sterojdi intrależjonali intervall ta' xahar.
#Triamcinolone intralesional injection
It-trattament bil-lejżer jista 'jiġi ppruvat għal eritema assoċjata ma' ċikatriċi, iżda l-injezzjonijiet ta 'triamcinilone jistgħu wkoll itejbu l-eritema billi jċattw iċ-ċikatriċi.
#Dye laser (e.g. V-beam)