Keloid
https://en.wikipedia.org/wiki/Keloid
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References
Keloid 29939676 NIH
Li-keloids li theha ka lebaka la pholoho e sa tloaelehang ka mor'a kotsi ea letlalo kapa ho ruruha. Mabaka a liphatsa tsa lefu le tikoloho a kenya letsoho ho kotsi ea tsona, ka litekanyetso tse phahameng tsa batho ba lebelang le letšo ba tsoang Afrika, Asia le Hispanic. Keloids e etsahala ha li-fibroblasts li sebetsa ho feta tekanyo, li hlahisa collagen e feteletseng le mabaka a ho hōla. Sena se lebisa ho thehoeng ha lihlopha tse kholo, tse sa tloaelehang tsa collagen tse tsejoang e le keloidal collagen, hammoho le keketseho ea fibroblasts. Ho ea ka meriana, li-keloid li hlaha e le li-nodules tse tiileng, tse nang le rabara libakeng tse le mong. Ho fapana le maqeba a tloaelehileng, li-keloid li fetela ka n'ane ho sebaka sa pele sa mahlomola. Bakuli ba ka utloa bohloko, ho hlohlona, kapa ho cha. Liphekolo tse fapaneng li teng, ho kenyelletsa li-ente tsa steroid, cryotherapy, opereishene, radiotherapy le 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.
Keloid treatments: an evidence-based systematic review of recent advances 36918908 NIH
Lipatlisis tsa morao‑rao li bontša hore gel ea silicone kapa sheeting e kopantsoeng le liente tsa corticosteroid ke phekolo ea pele e ratwago bakeng sa keloids. Liphekolo tse ling, joalo ka intralesional 5‑fluorouracil (5‑FU), bleomycin, kapa verapamil, li ka nkoa, leha katleho ea tsona e fapana. Ha kalafo ea laser e kopanngoa le liente tsa corticosteroid kapa li‑topical steroids tlas'a ts'oaetso, e ka ntlafatsa ho kenella ha lithethefatsi. Bakeng sa keloids e sa arabelang (recalcitrant), ho tlosoa ha opereopshene ho lateloa ke phekolo ea mahlaseli a kotsi ho bontša hore ho sebetsa. Qetellong, ho sebelisa silicone sheeting le kalafo ea khatello ho ipapisitse ho fokotsa monyetla oa phetoho ea keloid.
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.
Keloids: a review of therapeutic management 32905614 NIH
Hajoale, ha ho na kalafo e lekanang le e 'ngoe e netefatsang sekhahla se tlase sa ho ipheta ha keloids. Leha ho le joalo, likhetho tse ntseng li hola, joalo ka ho sebelisa lasers hammoho le li‑steroids kapa ho kopanya 5‑fluorouracil le li‑steroids, li tšepisa. Liphuputso tsa nakong e tlang li ka shebana le hore na liphekolo tse ncha, tse kang autologous grafting kapa stem cell‑based therapies, li tla sebetsa hantle ho laola 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.
Scar Revision 31194458 NIH
Maqeba ke karolo e tloaelehileng ea mokhoa oa ho folisa ka mor'a likotsi tsa letlalo. Ha e le hantle, maqeba a lokela ho ba a bataletseng, a tšesaane, ’me a tsamaisane le mala oa letlalo. Lintho tse ngata li ka etsa hore maqeba a fole, a kang tšoaetso, ho fokotseha ha phallo ea mali, ischemia le ho sithabela maikutlo. Maqeba a teteaneng, a lefifi ho feta letlalo le potolohileng, kapa a honyela haholo, a ka baka mathata a bohlokoa ka ts'ebetso ea ’mele le bophelo bo botle ba maikutlo.
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.
Maqeba a Keloid a bonoa hangata ho batho ba Maafrika, Maasia, kapa Masepanishe. Batho ba pakeng tsa lilemo tse 10 le 30 ba na le tšekamelo e phahameng ea ho hlahisa keloid ho feta batho ba hōlileng.
Leha hangata li etsahala sebakeng se folisitsoeng, keloid le eona e ka itlhahela feela. Li ka hlaha sebakeng sa ho phunya kapa ho tloha ho ntho e bonolo joaloka pimple kapa mongoapo. Li ka hlaha ka lebaka la maqeba a matla kapa a khohopox, tšoaetso sebakeng sa leqeba, ho tsieleha khafetsa sebakeng, kapa tsitsipano e feteletseng ea letlalo nakong ea ho koaloa ha maqeba kapa ‘mele o se nang leqeba.
Maqeba a Keloid a ka hlaha ka mor’a ho buuoa. Li atile haholo libakeng tse ling, tse kang sefuba se bohareng (ho tloha ho sternotomy), mokokotlo le mahetla (hangata a bakoa ke maqoqomete a makhopho), le lobes tsa tsebe (ho phunngoa litsebe). Li ka boela tsa hlaha ka ho phunya ‘mele. Matheba a tloaelehileng haholo ke earlobes, matsoho, pelvic region, le holim’a lesapo la molaleng.
Liphekolo tse teng ke kalafo ea khatello, silicone gel sheeting, intra‑lesional triamcinolone acetonide, cryosurgery, radiation, laser therapy, Interferon, 5‑FU le excision ea opereishene.
○ Kalafo
Maqeba a hypertrophic a ka ntlafala ka liente tse 5 ho isa ho tse 10 tsa intralesional steroid ka nako ea khoeli e le ’ngoe.
#Triamcinolone intralesional injection
Kalafo ea laser e ka ’na ea sebelisoa bakeng sa erythema e amanang le scarring, empa liente tsa triamcinolone li ka boela tsa ntlafatsa erythema ka ho fokotsa lebala.
#Dye laser (e.g. V‑beam)