Keloid
☆ Kwiziphumo zika-2022 ze-Stiftung Warentest ezivela eJamani, ukwaneliseka kwabathengi ngeModelDerm bekungaphantsi kancinci kunokubonisana nge-telemedicine ehlawulweyo.
I-keloid yasemva kotyando esihlahleni esanyangwa ngenaliti ye-triamcinolone ye-intralesional. Indawo ye-erythema etshoniweyo kwicala lasekhohlo yindawo enyangweyo.
Linear Keloids. Xa zivela kumphezulu womzimba womzimba, zidla ngokuvela ngokwemilo emgceni.
Posterior auricular Keloid
Keloids kwiinyawo zeenyawo zinokungakhululeki ukuhamba.Iinaliti ze-Intralesional steroid zidla ngokuqhutywa ngamaxesha amaninzi.
Keloids zibonwa ngokuqhelekileyo kwiingalo eziphezulu.
Ukubonakaliswa okuqhelekileyo kwesifuba keloids.
References
Ifom ye-Keloids ngenxa yokuphiliswa okungaqhelekanga emva kokulimala kwesikhumba okanye ukuvuvukala. Imiba yemfuza neyendalo inegalelo ekukhuleni kwabo, yaye amanani aphezulu kubantu abalusu oluntsundu abasuka eAfrika, eAsia, naseHispanics. I-Keloids iyenzeka xa iifibroblasts zisebenza kakhulu, zivelisa i-collagen eninzi kunye nezinto ezikhulayo. Oku kukhokelela ekwenziweni kweenyanda ezinkulu, ezingaqhelekanga ze-collagen ezaziwa ngokuba yi-keloidal collagen, kunye nokwanda kwe-fibroblasts. Ngokonyango, ii-keloids zibonakala ziqinile, amaqhuqhuva erabha kwiindawo ezenzakeleyo ngaphambili. Ngokungafaniyo nezivubeko eziqhelekileyo, ii-keloids zidlulela ngaphaya kwendawo yokwenzakala. Izigulana zinokuva iintlungu, ukurhawuzelelwa, okanye ukutshisa. Unyango olwahlukeneyo luyafumaneka, kuquka inaliti ye-steroid, i-cryotherapy, utyando, iradiotherapy, kunye nonyango lwelaser.
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.
Uphando lwangoku lubonisa ukuba ijeli ye-silicone okanye i-sheeting kunye nenaliti ye-corticosteroid yolona nyango lukhethiweyo lokuqala lwe-keloids. Unyango olongezelelweyo olufana ne-intralesional 5-fluorouracil (5-FU) , i-bleomycin, okanye i-verapamil nayo inokuqwalaselwa, nangona ukusebenza kwayo kuyahluka. Unyango lweLaser, xa ludityaniswe nenaliti ye-corticosteroid okanye i-topical steroids phantsi kwe-occlusion, inokuphucula ukungena kwamachiza. Kwi-recalcitrant keloids, ukususwa ngotyando olulandelwa lunyango olukhawulezayo lweradiation lubonise ukuba luyasebenza. Okokugqibela, ukusebenzisa i-silicone sheeting kunye nonyango loxinzelelo kuye kwangqinwa ukunciphisa amathuba okuba i-keloid iphindeke.
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.
Okwangoku, akukho nyango lulingana-konke oluqinisekisa umlinganiselo ophantsi wokuphindaphinda kwee-keloids. Nangona kunjalo, ukhetho olukhulayo, njengokusebenzisa i-laser ecaleni kwe-steroids okanye ukudibanisa i-5-fluorouracil kunye ne-steroids, zibonakalisa ukuthembisa. Uphando lwexesha elizayo lunokujolisa kwindlela unyango olutsha olusebenza kakuhle ngayo, olufana ne-autologous fat grafting okanye i-stem cell-based therapies, umsebenzi wokulawula i-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.
Izibazi ziyinxalenye eqhelekileyo yenkqubo yokuphilisa emva kokulimala kwesikhumba. Ngokufanelekileyo, izibonda kufuneka zibe mcaba, zincinci, kwaye zihambelane nombala wolusu. Izinto ezininzi zinokukhokelela ekungaphili kakuhle kwenxeba, njengosulelo, ukunciphisa ukuhamba kwegazi, ischemia, kunye nokwenzakala. Izikrweqe ezishinyeneyo, ezimnyama kunolusu olujikelezileyo, okanye ezishwabene kakhulu zinokubangela imiba ebalulekileyo ngomsebenzi womzimba kunye nempilo yeemvakalelo.
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.
Izivubeko ze-Keloid zibonwa rhoqo kubantu baseAfrika, baseAsia, okanye baseHispanic. Abantu abaphakathi kweminyaka eyi-10 kunye ne-30 iminyaka banotyekelo oluphezulu lokuphuhlisa i-keloid kunabantu abadala.
Nangona ziqhele ukwenzeka kwindawo yokwenzakala, keloid inokuvela ngokuzenzekelayo. Zingenzeka kwindawo yokugqobhoza nakwinto elula njengeqhakuva okanye umkrwelo. Zinokuthi zenzeke ngenxa ye-acne enzima okanye i-chickenpox scarring, ukusuleleka kwindawo yenxeba, ukwenzakala ngokuphindaphindiweyo kwindawo ethile, ukuxinezeleka okugqithisileyo kwesikhumba ngexesha lokuvalwa kwenxeba okanye umzimba wangaphandle kwinxeba.
Izibazi ze-Keloid zinokukhula emva kotyando. Zixhaphake ngakumbi kwezinye iindawo, njengesifuba esisembindini (esisuka kwi-sternotomy), umqolo namagxa (adla ngokuphuma kumaqhakuva), kunye namaqhakuva endlebe (ukugqojozwa kweendlebe). Zisenokwenzeka nasekugqobhozeni umzimba. Ezona ndawo zixhaphakileyo ziindlebe, iingalo, ummandla we-pelvic, nangaphezulu kwethambo lekhola.
Unyango olukhoyo lunyango loxinzelelo, i-silicone gel sheeting, i-intra-lesional triamcinolone acetonide, i-cryosurgery, i-radiation, i-laser therapy, i-Interferon, i-5-FU kunye nokukhutshwa kotyando.
○ Unyango
Izibazi ze-Hypertrophic zinokuphucula kunye ne-5 ukuya kwi-10 ye-intralesional steroid injections 1 inyanga.
#Triamcinolone intralesional injection
Unyango lweLaser lusenokuzanywa i-erythema eyayanyaniswa nokukrala, kodwa iinaliti ze-triamcinilone zisenokuphucula i-erythema ngokusicaba isiva.
#Dye laser (e.g. V-beam)