Keloid
☆ Emiphumeleni ka-2022 ye-Stiftung Warentest evela eJalimane, ukwaneliseka kwabathengi nge-ModelDerm bekungaphansi kancane kunokuxhumana okukhokhelwayo kwe-telemedicine.
I-keloid yangemva kokuhlinzwa esihlakaleni esilashwe ngomjovo we-triamcinolone we-intralesional. Indawo eshonelwe i-erythema ohlangothini lwesobunxele yindawo ephathwayo.
Linear Keloids. Uma zenzeka engxenyeni engenhla ye-torso, zivame ukuvela ngendlela eqondile.
Posterior auricular Keloid
Keloids ematheni ezinyawo kungase kungakhululeki ukuhamba.Imijovo ye-Intralesional steroid ngokuvamile yenziwa izikhathi eziningana.
Keloids ivame ukubonwa ezingalweni ezingaphezulu.
Ukubonakaliswa okujwayelekile kwesifuba keloids.
References
I-Keloids yakha ngenxa yokuphulukiswa okungavamile ngemva kokulimala kwesikhumba noma ukuvuvukala. Izici zofuzo nezemvelo zinomthelela ekuthuthukisweni kwazo, ngamanani aphezulu kubantu abanebala elinsundu bomdabu wase-Afrika, wase-Asia, kanye nowase-Hispanic. I-Keloids iyenzeka lapho ama-fibroblasts esebenza ngokweqile, akhiqiza i-collagen ngokweqile kanye nezici zokukhula. Lokhu kuholela ekwakhekeni kwenqwaba ye-collagen enkulu, engavamile eyaziwa ngokuthi i-keloidal collagen, kanye nokwanda kwama-fibroblasts. Ngokomtholampilo, ama-keloid avela njengamaqhuqhuva aqinile, erabha ezindaweni ezilimele ngaphambilini. Ngokungafani nezibazi ezivamile, ama-keloid adlulela ngale kwesayithi lokuhlukumezeka kwasekuqaleni. Iziguli zingase zizwe ubuhlungu, ukulunywa, noma ukusha. Izindlela zokwelapha ezihlukahlukene ziyatholakala, okuhlanganisa imijovo ye-steroid, i-cryotherapy, ukuhlinzwa, i-radiotherapy, nokwelashwa nge-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.
Ucwaningo lwamanje luphakamisa ukuthi ijeli ye-silicone noma i-sheeting kanye nemijovo ye-corticosteroid iyindlela yokwelapha yokuqala ethandwayo yama-keloids. Ukwelashwa okwengeziwe okufana ne-intralesional 5-fluorouracil (5-FU) , i-bleomycin, noma i-verapamil nakho kungacatshangelwa, nakuba ukusebenza kwakho kwehluka. Ukwelashwa nge-laser, lapho kuhlanganiswa nemijovo ye-corticosteroid noma ama-topical steroids ngaphansi kokuvaleka, kungathuthukisa ukungena kwezidakamizwa. Kuma-keloid e-recalcitrant, ukususwa kokuhlinzwa okulandelwa ukwelashwa ngemisebe ngokushesha kubonise ukuthi kusebenza ngempumelelo. Okokugcina, ukusebenzisa i-silicone sheeting kanye nokwelashwa kwengcindezi kuye kwafakazelwa ukunciphisa amathuba okuphindaphinda kwe-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.
Okwamanje, alukho uhlobo olulodwa lokwelapha oluqinisekisa izinga eliphansi lokuphindeka eliphansi lama-keloids. Kodwa-ke, izinketho ezikhulayo, njengokusebenzisa amalaser eceleni kwe-steroids noma ukuhlanganisa i-5-fluorouracil nama-steroids, kuyathembisa. Ucwaningo lwangomuso lungagxila ekutheni izindlela zokwelapha ezintsha, ezifana nokuxhunyelelwa kwamafutha e-autologous noma ama-stem cell-based therapy, zisebenza kahle kangakanani ekulawuleni ama-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.
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 ziyingxenye evamile yenqubo yokuphulukisa ngemva kokulimala kwesikhumba. Ngokufanelekile, izibazi kufanele zibe zicaba, zibe mncane, futhi zihambisane nombala wesikhumba. Ziningi izici ezingaholela ekupholeni kabi kwesilonda, njengokutheleleka, ukunciphisa ukugeleza kwegazi, i-ischemia, nokuhlukumezeka. Izibazi eziwugqinsi, ezimnyama kunesikhumba esizungezile, noma ezishwabene kakhulu zingabangela izinkinga ezibalulekile kukho kokubili ukusebenza komzimba nempilo yemizwa.
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.
Izibazi ze-Keloid zibonakala kaningi kubantu base-Afrika, base-Asia, noma base-Hispanic. Abantu abaphakathi kweminyaka eyi-10 nengama-30 banokuthambekela okuphezulu kokuthuthukisa i-keloid kunabantu asebekhulile.
Nakuba zivame ukwenzeka endaweni yokulimala, keloid zingase zivele ngokuzenzekelayo. Zingenzeka endaweni yokubhoboza ngisho nasentweni elula njengenduna noma ukuklwebheka. Zingenzeka ngenxa yezibazi ezinzima noma izibazi zenkukhu, ukutheleleka endaweni yenxeba, ukuhlukumezeka okuphindaphindiwe endaweni, ukucindezeleka okweqile kwesikhumba ngesikhathi sokuvalwa kwenxeba noma umzimba wangaphandle esilondeni.
Izibazi ze-Keloid zingavela ngemva kokuhlinzwa. Zivame kakhulu kwezinye izingosi, njengesifuba esimaphakathi (kusuka ku-sternotomy), umhlane namahlombe (ngokuvamile okubangelwa yizinduna), kanye nezimbobo zendlebe (ezivela ekubhobhozweni kwezindlebe). Zingenzeka nasekubhobozeni umzimba. Izindawo ezivame kakhulu ama-earlobes, izingalo, indawo ye-pelvic, naphezu kwethambo lekholomu.
Ukwelashwa okutholakalayo i-pressure therapy, i-silicone gel sheeting, i-intra-lesional triamcinolone acetonide, i-cryosurgery, i-radiation, i-laser therapy, i-Interferon, i-5-FU kanye nokusikwa ngokuhlinzwa.
○ Ukwelashwa
Izibazi ze-hypertrophic zingathuthuka ngemijovo ye-intralesional steroid emi-5 kuye kwayi-10 isikhathi esingangenyanga engu-1.
#Triamcinolone intralesional injection
Ukwelashwa nge-laser kungase kuzanywe i-erythema ehambisana nezibazi, kodwa imijovo ye-triamcinilone ingase futhi ithuthukise i-erythema ngokuthambisa isibazi.
#Dye laser (e.g. V-beam)