Keloid
☆ Mune 2022 Stiftung Warentest mhedzisiro kubva kuGermany, kugutsikana kwevatengi neModelDerm kwakangodzikira zvishoma pane nekubhadharwa kwe telemedicine kubvunzana.
A postoperative keloid paruoko iyo yakabatwa ne triamcinolone intralesional jekiseni. Nzvimbo yakanyura erythema kudivi rekuruboshwe ndiyo inorapwa.
Linear Keloids. Kana dzichiitika kumberi kwepamusoro pemuviri, dzinowanzoonekwa mumutsara.
Posterior auricular Keloid
Keloids pamakumbo etsoka anogona kunge asina kugadzikana kufamba pa.Intralesional steroid majekiseni anowanzoitwa kakawanda.
Keloids inowanzoonekwa pamaoko epamusoro.
Yakajairika kuratidzwa kwechipfuva keloids.
References
Keloids inoumba nekuda kwekuporesa kusingawanzo mushure mekukuvara kweganda kana kuzvimba. Genetic uye zvakatipoteredza zvinhu zvinobatsira mukukura kwavo, nehuwandu hwepamusoro muvanhu vane ganda rakasviba veAfrica, Asia, uye Hispanic dzinza. Keloids inoitika kana fibroblasts ikanyanya kushanda, ichigadzira yakawandisa collagen uye kukura zvinhu. Izvi zvinotungamirira kukugadzirwa kwehombe, isina kujairika collagen bundles inozivikanwa se keloidal collagen, pamwe chete nekuwedzera kwe fibroblasts. Mukiriniki, keloids inoratidzika seyakasimba, rubbery nodules munzvimbo dzakambokuvadzwa. Kusiyana nemavanga akajairwa, keloids inotambanudzira kupfuura iyo yekutanga trauma saiti. Varwere vanogona kunzwa kurwadziwa, kukwenya, kana kupisa. Mishonga yakasiyana-siyana iripo, kusanganisira jekiseni resteroid, cryotherapy, kuvhiyiwa, radiotherapy, uye 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.
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.
Tsvagiridzo yazvino inoratidza kuti silicone gel kana sheeting pamwe nejekiseni recorticosteroid ndiyo inofarirwa yekutanga kurapwa kwekeloids. Mamwe marapirwo akadai se intralesional 5-fluorouracil (5-FU) , bleomycin, kana verapamil anogonawo kutariswa, kunyangwe kushanda kwawo kuchisiyana. Laser therapy, kana yasanganiswa ne corticosteroid jekiseni kana topical steroid pasi pekuvhara, inogona kuwedzera kupinda kwemishonga. Kune recalcitrant keloids, kubviswa kwekuvhiya kunoteverwa nekukasira kurapwa nemwaranzi kwakaratidza kuve kunoshanda. Chekupedzisira, kushandisa silicone sheeting uye kurapa kwekumanikidza kwakaratidza kudzikisa mukana wekeloid kudzokorora.
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.
Parizvino, hapana-saizi-inokodzera-ese kurapwa inovimbisa kugara yakaderera kudzokorora mwero wekeloids. Nekudaro, sarudzo dziri kukura, sekushandisa lasers padivi pesteroids kana kubatanidza 5-fluorouracil nesteroids, zviri kuratidza kuvimbisa. Tsvagiridzo yeramangwana inogona kutarisa nezve kurapwa kutsva, senge autologous mafuta grafting kana stem cell-based therapies, inoshanda kubata 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.
Mavanga ndiwo akajairika chikamu chekupora mushure mekukuvara kweganda. Zvakanakisa, mavanga anofanira kunge akati sandara, matete, uye anoenderana nemuvara weganda. Zvinhu zvakawanda zvinogona kukonzera kuporeswa kwemaronda kwakashata, senge kutapukirwa, kuderera kwekuyerera kweropa, ischemia, uye kushungurudzika. Mavanga akakora, akasviba kupfuura ganda rakatenderedza, kana kuderera zvakanyanya anogona kukonzera nyaya dzakakosha nebasa remuviri uye hutano hwepfungwa.
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.
Mavanga eKeloid anoonekwa kakawanda muvanhu veAfrica, Asia, kana Hispanic dzinza. Vanhu vari pakati pemakore e10 ne30 vane tsika yakakwirira yekugadzira keloid kupfuura vakwegura.
Kunyangwe zvinowanzoitika panzvimbo yekukuvara, keloid inogonawo kusimuka yega. Zvinogona kuitika panzvimbo yekuboorwa uye kunyange kubva kune chinhu chakareruka sebundu kana kukwenya. Zvinogona kuitika semugumisiro wehuputi hwakanyanya kana chickenpox scarring, utachiona panzvimbo yeronda, kudzokorora kushungurudza kune imwe nzvimbo, kunyanya kunetseka kweganda panguva yekuvharwa kwemaronda kana mutumbi wekunze mune ronda.
Keloid mavanga anogona kukura mushure mekuvhiyiwa. Dzinowanzoitika mune dzimwe nzvimbo, dzakadai sepakati pechipfuva (kubva kusternotomy), musana nemapfudzi (kazhinji kacho zvinokonzerwa neburwa), uye nzeve (kubva pakuboorwa nzeve). Zvinogonawo kuitika pakuboora muviri. Mavara anonyanyozivikanwa ndeenzeve, maoko, pelvic region, uye pamusoro pecollar bone.
Mishonga iripo ipressure therapy, silicone gel sheeting, intra-lesional triamcinolone acetonide, cryosurgery, radiation, laser therapy, Interferon, 5-FU uye kuvhiya.
○ Kurapa
Hypertrophic scars inogona kuvandudza ne5 kusvika ku10 intralesional steroid majekiseni 1 mwedzi kupindirana.
#Triamcinolone intralesional injection
Kurapa nelaser kunogona kuyedzwa erythema ine mavanga, asi majekiseni etriamcinilone anogonawo kuvandudza erythema nekudzikamisa vanga.
#Dye laser (e.g. V-beam)