Keloid
☆ Ninu awọn abajade 2022 Stiftung Warentest lati Jẹmánì, itẹlọrun alabara pẹlu ModelDerm jẹ kekere diẹ ju pẹlu awọn ijumọsọrọ telemedicine isanwo.
keloid lẹhin isẹ abẹ lori ọwọ ti a ṣe itọju pẹlu abẹrẹ intralesional triamcinolone. Agbegbe erythema sunken ni apa osi ni agbegbe itọju.
Linear Keloids. Nigbati wọn ba waye ni iwaju oke ti torso, wọn nigbagbogbo han ni apẹrẹ laini.
Keloid auricular lẹhin
Keloids lori awọn atẹlẹsẹ ẹsẹ le jẹ korọrun lati rin lori. Awọn abẹrẹ sitẹriọdu intralesional ni a maa n ṣe ni igba pupọ.
Keloids ni a ṣe akiyesi nigbagbogbo lori awọn apa oke.
Ifihan aṣoju ti awọn keloids àyà.
References
Keloids dagba nitori iwosan dani lẹhin ipalara awọ-ara tabi igbona. Jiini ati awọn ifosiwewe ayika ṣe alabapin si idagbasoke wọn, pẹlu awọn oṣuwọn ti o ga julọ ni awọn eniyan dudu dudu ti Afirika, Esia, ati iran-iran Hispaniki. Awọn keloids waye nigbati awọn fibroblasts di alaapọn, ti n ṣe iṣelọpọ kolaginni pupọ ati awọn ifosiwewe idagbasoke. Eyi nyorisi idasile nla, awọn edidi collagen ajeji ti a mọ si keloidal collagen, pẹlu ilosoke ninu awọn fibroblasts. Ni ile-iwosan, awọn keloids han bi iduroṣinṣin, awọn nodules rubbery ni awọn agbegbe ti o farapa tẹlẹ. Ko dabi awọn aleebu deede, awọn keloids fa kọja aaye ibalokanjẹ atilẹba. Awọn alaisan le ni iriri irora, nyún, tabi sisun. Awọn itọju oriṣiriṣi wa, pẹlu awọn abẹrẹ sitẹriọdu, cryotherapy, iṣẹ abẹ, radiotherapy, ati itọju laser.
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.
Iwadi lọwọlọwọ ni imọran pe gel silikoni tabi dì pẹlu awọn abẹrẹ corticosteroid jẹ itọju akọkọ ti o fẹ fun awọn keloids. Awọn itọju afikun bi intralesional 5-fluorouracil (5-FU) , bleomycin, tabi verapamil tun le gbero, botilẹjẹpe imunadoko wọn yatọ. Itọju ailera lesa, nigba ti a ba ni idapo pẹlu awọn abẹrẹ corticosteroid tabi awọn sitẹriọdu ti agbegbe labẹ occlusion, le mu ilaluja ti awọn oogun pọ si. Fun awọn keloids recalcitrant, yiyọ iṣẹ-abẹ ti o tẹle pẹlu itọju ailera itọnju lẹsẹkẹsẹ ti fihan pe o munadoko. Nikẹhin, lilo silikoni dì ati itọju ailera ti a ti fihan lati dinku o ṣeeṣe ti atunṣe 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.
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.
Lọwọlọwọ, ko si ọkan-iwọn-ni ibamu-gbogbo itọju ti o ṣe iṣeduro oṣuwọn atunṣe kekere nigbagbogbo fun keloids. Sibẹsibẹ, awọn aṣayan dagba, bii lilo awọn laser lẹgbẹẹ awọn sitẹriọdu tabi apapọ 5-fluorouracil pẹlu awọn sitẹriọdu, n ṣe afihan ni ileri. Iwadi ojo iwaju le dojukọ bawo ni awọn itọju tuntun ti dara daradara, gẹgẹbi jijẹ ọra ti ara ẹni tabi awọn itọju ti o da lori sẹẹli, ṣiṣẹ fun ṣiṣakoso awọn 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.
Awọn aleebu jẹ apakan ti o wọpọ ti ilana imularada lẹhin awọn ipalara awọ ara. Bi o ṣe yẹ, awọn aleebu yẹ ki o jẹ alapin, tinrin, ki o baamu awọ ara. Ọpọlọpọ awọn okunfa le ja si iwosan ọgbẹ ti ko dara, gẹgẹbi ikolu, sisan ẹjẹ ti o dinku, ischemia, ati ibalokanjẹ. Awọn aleebu ti o nipọn, dudu ju awọ ara agbegbe lọ, tabi dinku pupọ le fa awọn ọran pataki pẹlu iṣẹ ṣiṣe ti ara ati ilera ẹdun.
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.
Awọn aleebu Keloid ni a rii nigbagbogbo nigbagbogbo ni awọn eniyan Afirika, Esia, tabi idile Hispaniki. Awọn eniyan laarin awọn ọjọ ori 10 ati 30 ọdun ni ifarahan ti o ga julọ lati ṣe idagbasoke keloid ju awọn agbalagba lọ.
Botilẹjẹpe wọn maa n waye ni aaye ti ipalara kan, keloid tun le dide lairotẹlẹ. Wọn le waye ni aaye ti lilu ati paapaa lati nkan ti o rọrun bi pimple tabi ibere. Wọn le waye bi abajade irorẹ ti o lagbara tabi ọgbẹ adiẹ, ikolu ni aaye ọgbẹ, ibalokanjẹ tun si agbegbe kan, ẹdọfu awọ ara ti o pọju nigba pipade ọgbẹ tabi ara ajeji ninu ọgbẹ kan.
Awọn aleebu Keloid le dagbasoke lẹhin iṣẹ abẹ. Wọn wọpọ julọ ni awọn aaye kan, gẹgẹbi aarin àyà (lati inu sternotomy), ẹhin ati awọn ejika (eyiti o maa nwaye lati irorẹ), ati awọn lobes eti (lati awọn lilu eti). Wọn tun le waye lori awọn lilu ara. Awọn aaye ti o wọpọ julọ jẹ awọn eti eti, awọn apa, agbegbe pelvic, ati lori egungun kola.
Awọn itọju ti o wa ni itọju titẹ, silikoni gel sheeting, intra-lesional triamcinolone acetonide, cryosurgery, radiation, laser therapy, Interferon, 5-FU ati excision abẹ.
○ Itọju
Awọn aleebu hypertrophic le ni ilọsiwaju pẹlu 5 si 10 intralesional sitẹriọdu abẹrẹ aarin oṣu kan.
#Triamcinolone intralesional injection
Itọju lesa le ṣe idanwo fun erythema ti o ni nkan ṣe pẹlu ọgbẹ, ṣugbọn awọn abẹrẹ triamcinilone tun le mu erythema naa dara nipasẹ didan aleebu naa.
#Dye laser (e.g. V-beam)