Keloids: a review of therapeutic management
Top Cited Papers
- 9 September 2020
- journal article
- review article
- Published by Wiley in International Journal of Dermatology
- Vol. 60 (6), 661-671
- https://doi.org/10.1111/ijd.15159
Abstract
Keloid scar formation arises from a disorganized fibroproliferative collagen response that extends beyond the original wound margins because of excessive production of extracellular matrix (ECM). Despite treatment options for keloid scars including medical and surgical therapies, such as intralesional steroid injection and surgical excision, the recurrence rate remains high. Herein we consolidate recently published narrative reviews, systematic reviews, and meta‐analyses to provide an overview of updated treatment recommendations for keloidal scar formation. PubMed search engine was used to access the MEDLINE database to investigate updates regarding keloid incidence and treatment. More than 100 articles were reviewed. Keloid management remains a multimodal approach. 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 (5‐FU) 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. This review article provides updated treatment guidelines for keloids and discusses insight into management to assist patient‐focused, evidence‐based clinical decision making.Keywords
Funding Information
- National Cancer Institute (CA215105)
This publication has 106 references indexed in Scilit:
- Management of keloids and hypertrophic scars: current and emerging optionsClinical, Cosmetic and Investigational Dermatology, 2013
- Outcomes of Surgical Excision with Pressure Therapy Using Magnets and Identification of Risk Factors for Recurrent KeloidsPlastic and Reconstructive Surgery, 2011
- Effect of carbon dioxide laser ablation followed by intralesional steroids on keloidsJournal of Cutaneous and Aesthetic Surgery, 2011
- An Open, Randomized, Controlled, Comparative Study of the Combined Effect of Intralesional Triamcinolone Acetonide and Onion Extract Gel and Intralesional Triamcinolone Acetonide Alone in the Treatment of Hypertrophic Scars and KeloidsDermatologic Surgery, 2008
- Management of external ear keloids using form-pressure therapyClinical and Experimental Dermatology, 2008
- mTOR as a potential therapeutic target for treatment of keloids and excessive scarsExperimental Dermatology, 2007
- Treatment of keloids and hypertrophic scars with dermojet injections of bleomycin: a preliminary studyInternational Journal of Dermatology, 2005
- Suppressed TGF-?1 expression is correlated with up-regulation of matrix metalloproteinase-13 in keloid regression after flashlamp pulsed-dye laser treatmentLasers in Surgery and Medicine, 2005
- Transforming Growth Factor-betamRNA and Protein in Hypertrophic Scar Tissues and Fibroblasts: Antagonism by IFN-alphaand IFN-gammaIn VitroandIn VivoJournal of Interferon & Cytokine Research, 2000
- UVA1 for Treatment of KeloidsActa Dermato-Venereologica, 1999