Keloid
https://en.wikipedia.org/wiki/Keloid
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References
Keloid 29939676 NIH
Keloids kabentuk alatan penyembuhan mahiwal sanggeus tatu kulit atawa peradangan. Faktor genetik sareng lingkungan nyumbang kana kamekaranana, kalayan tingkat anu langkung luhur dina jalma anu kulitna langkung poék turunan Afrika, Asia, sareng Hispanik. Keloids lumangsung nalika fibroblasts jadi overactive, ngahasilkeun kolagén kaleuleuwihan sarta faktor pertumbuhan. Ieu ngakibatkeun formasi badag, bundel kolagén abnormal katelah kolagén keloidal, babarengan jeung paningkatan dina fibroblasts. Sacara klinis, keloid némbongan salaku nodul karét anu teguh di daérah anu luka saméméhna. Teu kawas tatu normal, keloids ngalegaan saluareun situs trauma aslina. Pasén bisa ngalaman nyeri, gatal (itching), atawa kaduruk.
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
Panaliti ayeuna nunjukkeun yén gél silikon (silicone gel) atanapi lembaran (sheeting) sareng suntikan kortikosteroid (corticosteroid injection) mangrupikeun perlakuan awal anu dipikaresep pikeun keloid. Pangobatan tambahan sapertos intralesional 5-fluorouracil (5-FU), bleomycin, atanapi verapamil ogé tiasa dipertimbangkeun, sanaos éféktivitasna béda‑béda. Terapi laser (laser therapy), nalika digabungkeun sareng suntikan kortikosteroid (corticosteroid injection) atanapi stéroid topikal (topical steroid) dina kaayaan halangan, tiasa ningkatkeun penetrasi obat. Pikeun keloids recalcitrant, panyabutan bedah (surgical excision) dituturkeun ku terapi radiasi (radiation therapy) saharita geus ditémbongkeun éféktif. Tungtungna, ngagunakeun lembaran silikon (silicone sheeting) sareng terapi tekanan (pressure therapy) parantos kabuktosan ngirangan kamungkinan kambuh 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
Ayeuna, teu aya hiji‑ukuran‑cocog‑kabeh perlakuan anu ngajamin tingkat kambuh konsistén low pikeun keloids. Nanging, pilihan anu ngembang, sapertos nganggo laser sareng steroid atanapi ngagabungkeun 5‑fluorouracil sareng steroid, ngabuktikeun ngajangjikeun. Panalitian anu bakal datang tiasa difokuskeun kumaha perlakuan anyar, sapertos autologous fat grafting atanapi stem cell‑based therapies, tiasa dianggo pikeun ngatur 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.
Scar Revision 31194458 NIH
Parut mangrupakeun bagian umum tina prosés penyembuhan sanggeus tatu kulit. Ideally, scars kudu datar, ipis, sarta cocog warna kulit. Loba faktor bisa ngakibatkeun penyembuhan tatu goréng, kayaning inféksi, ngurangan aliran getih, iskemia, sarta trauma. Parut proliferatif, hiperpigmentasi, atawa kontraktil tiasa nyababkeun masalah anu penting pikeun fungsi fisik sareng kaséhatan émosional.
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.
Tatu keloid nu katempo leuwih remen di urang Afrika, Asia, atawa katurunan Hispanik. Jalma antara umur 10 jeung 30 taun boga kacenderungan luhur ngamekarkeun keloid tibatan manula.
Sanajan biasana lumangsung dina situs tatu, keloid ogé bisa timbul sacara spontan. Éta bisa lumangsung dina situs piercing atawa tina hal basajan kawas jarawat atawa goresan. Éta ogé bisa timbul salaku hasil tina jarawat parna atawa scarring cacar, inféksi dina situs tatu, trauma terus‑terusan ka wewengkon, tegangan kulit kaleuleuwihan salila panutupan tatu, atawa awak asing dina tatu.
Tatu keloid bisa ngamekarkeun sanggeus bedah. Aranjeunna langkung umum di sababaraha situs, sapertos dada tengah (tina sternotomi), tonggong sareng taktak (biasana disababkeun ku jarawat), sareng lobus ceuli (tina piercing ceuli). Éta ogé bisa lumangsung dina piercings awak. Bintik nu paling umum nyaéta cuping ceuli, leungeun, wewengkon pelvis, sarta tulang kerah.
Perawatan anu sayogi nyaéta terapi tekanan, lembaran gél silikon, triamcinolone acetonide intra‑lesional, cryoterapi (cryosurgery), radiasi, terapi laser, interferon, 5‑FU, sareng eksisi bedah.
○ Perlakuan
Tatu hipertrofik bisa ningkat kalawan 5 nepi ka 10 suntikan stéroid intralesional interval 1 bulan.
#Triamcinolone intralesional injection
Perlakuan laser bisa dicoba pikeun eritema (erythema) pakait sareng scarring, tapi suntik triamcinolone ogé bisa ningkatkeun eritema ku flattening tapak tatu.
#Dye laser (e.g. V‑beam)