Keloid
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Germaniyaning 2022 yilgi Stiftung Warentest natijalariga ko'ra, iste'molchilarning ModelDermdan qoniqish darajasi pullik teletibbiyot maslahatlariga qaraganda bir oz pastroq bo'lgan.
Germaniyaning 2022 yilgi Stiftung Warentest natijalariga ko'ra, iste'molchilarning ModelDermdan qoniqish darajasi pullik teletibbiyot maslahatlariga qaraganda bir oz pastroq bo'lgan.
Triamcinolone (Triamsinolon) intralesional injeksiya bilan davolangan bilakdagi operatsiyadan keyingi keloid. Chap tarafdagi cho‘kib ketgan eritema maydoni davolangan joydir.
Chiziqli keloidlar. Ular torso yuqori old qismida paydo bo'lganda, ko'pincha chiziqli shaklda namoyon bo'ladi.
Posterior aurikulyar keloid
Oyoq tagidagi keloidlar yurishni noqulay qilishi mumkin. Intralezyonal steroid in'ektsiyalari odatda bir necha marta beriladi.
Keloidlar odatda yuqori qo‘llarda paydo bo‘ladi.
Ko'krak keloidlarining tipik ko'rinishi.
relevance score : -100.0%
ReferencesKeloidlar terining shikastlanishi yoki yallig'lanishidan keyin g'ayrioddiy shifo tufayli hosil bo'ladi. Irsiy va atrof‑muhit omillari ularning rivojlanishiga hissa qo'shadi; afrikalik, osiyolik va ispaniyalik qora tanli odamlarda ko'rsatkichlar yuqori. Keloidlar fibroblastlar haddan tashqari faollashganda, ortiqcha kollagen va o'sish omillarini ishlab chiqqanda paydo bo'ladi. Bu fibroblastlarning ko'payishi bilan birga, keloid kollagen deb ataluvchi katta, g'ayritabiiy kollagen to'plamlarining shakllanishiga olib keladi. Klinik jihatdan keloidlar ilgari shikastlangan joylarda qattiq, rezina nodullar ko'rinishida namoyon bo'ladi. Oddiy chandiqlardan farqli o'laroq, keloidlar asl shikastlanish joyidan tashqariga chiqadi. Bemorlarda og'riq, qichishish yoki yonish hissi paydo bo'lishi mumkin. Ukol in'ektsiyalari, kriyoterapiya, jarrohlik, radioterapiya va lazer terapiyasi kabi turli davolash usullari mavjud.
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.
Hozirgi tadqiqotlar shuni ko'rsatadiki, silikon jel yoki choyshab kortikosteroid in'ektsiyalari bilan birga keloidlarni davolash uchun afzal qilingan birinchi davolash usuli hisoblanadi. Intralezyonal 5-ftorouratsil (5-FU), bleomitsin yoki verapamil kabi qo'shimcha davolash usullari ham ko'rib chiqilishi mumkin, ammo ularning samaradorligi farq qiladi. Lazer terapiyasi kortikosteroid in'ektsiyalari yoki okklyuziya ostida topikal steroidlar bilan birga dorilarning teriga kirib borishini kuchaytirishi mumkin. Rekalsitran keloidlar uchun jarrohlik yo'li bilan olib tashlash, so'ngra darhol radiatsiya terapiyasi samarali ekanligini ko'rsatdi. Nihoyat, silikon qoplama va bosim terapiyasidan foydalanish keloidning takrorlanish ehtimolini kamaytirishi isbotlangan.
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.
Hozirgi vaqtda keloidlar uchun doimiy, past takrorlanish darajasini kafolatlaydigan yagona o'lchamli davolash usuli yo'q. Biroq, steroidlar bilan bir qatorda, lazerlarni qo‘llash yoki 5-fluorouracilni steroidlar bilan birlashtirish kabi o‘sib borayotgan variantlar istiqbolli. Kelajakdagi tadqiqotlar keloidlarni boshqarishda yangi davolash usullari, masalan, yog‘ payvandlash yoki ildiz hujayralariga asoslangan terapiyaning qanchalik samarali ekanligiga e'tibor qaratishi mumkin.
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.
Skarlar teri jarohatlaridan keyin shifo jarayonining keng tarqalgan bir qismidir. Ideal holda, chandiqlar tekis, ingichka bo'lishi va terining rangiga mos kelishi kerak. Ko'pgina omillar yaralarning yomon davolanishiga olib kelishi mumkin, masalan, infektsiya, qon oqimining pasayishi, ishemiya va travma. Qalin, atrofdagi teriga qaraganda quyuqroq yoki haddan tashqari qisqaradigan chandiqlar ham jismoniy, ham hissiy salomatlik bilan bog'liq jiddiy muammolarni keltirib chiqarishi mumkin.
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.
Keloid chandiqlari ko‘proq afroamerikalik, osiyolik yoki ispaniyalik odamlarda uchraydi. 10‑30 yosh oralig‘idagi odamlar keloid rivojlanishiga, keksalarga qaraganda, ko‘proq moyil bo‘ladilar.
Ular odatda shikastlanish joyida paydo bo‘lishiga qaramasdan, o‘z‑o‘zidan ham paydo bo‘lishi mumkin. Pirsing, akne yoki tirnalish kabi oddiy holatlar ham keloidga olib kelishi mumkin. Akne yoki suvchechakning kuchli chandiqlari, yara joyida infektsiya, takroriy jarohatlar, yarani yopish paytida terining haddan tashqari tortilishi yoki yarada begona jismning mavjudligi ham keloidni keltirib chiqaradi.
Jarrohlikdan keyin keloid izlari paydo bo‘lishi mumkin. Ular ayniqsa markaziy ko‘krak (sternotomiyadan), orqa va elkada (odatda aknedan), hamda quloq bo‘shlig‘ida (quloq teshilishidan) ko‘proq uchraydi. Tana pirsinglarida ham keloidlar paydo bo‘lishi mumkin. Eng ko‘p uchraydigan joylar quloq bo‘shlig‘i, qo‘llar, tos mintaqasi va yoqa suyagi atrofidir.
Mavjud muolajalar: bosimli terapiya, silikon jel qoplamasi, intra‑lesional Triamcinolone acetate, kriyojarrohlik, radiatsiya, lazer terapiyasi, interferon, 5‑FU va jarrohlik eksizyondir.
○ Davolash
Gipertrofik chandiqlarni 1‑oylik interval bilan 5‑10 intra‑lesional steroid in’ektsiyalari bilan yaxshilash mumkin.
#Triamcinolone intralesional injection
Skarlanish bilan bog‘liq eritema uchun lazer terapiyasini sinab ko‘rish mumkin; shuningdek, Triamcinolone in’ektsiyalari ham chandiqni tekislash orqali eritemani kamaytiradi.
#Dye laser (e.g. V‑beam)