HYPERGRANULATED SCARkeloids AFTER WOUND MANAGEMENT

KELOIDS

1. KELOID SCAR

2. 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.

3. Patients may complain of pain, itching, or burning. 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. 

4. Clinical signs & symptoms Raised and thickened appearance Firm or rubbery texture Often pink, red, or purple in color May be itchy, painful, or tender Can grow larger over time

5. Causes Genetic predisposition Injury or trauma (e.g., cuts, burns, surgery) Infection Inflammation Hormonal changes

6. Types 1. Hypertrophic scars: similar to keloids but do not extend beyond wound boundaries 2. Acne keloids: form after acne lesions 3. Earlobe keloids: common after ear piercing

7. Prevention Proper wound care Using pressure dressings or silicone sheets Avoiding tight clothing Protecting the skin from sun exposure

8. The most common treatments include intralesional or topical steroids, cryotherapy, surgical excision, radiotherapy, and laser therapy.

9. TREATMENT Pre-Treatment Preparation: 1. Clean and dry the area 2. Remove makeup, oils, or lotions 3. Protect surrounding skin with dressing or shield Post-Treatment Care: 1. Apply topical antibiotic ointment 2. Avoid direct sun exposure 3. Use sunscreen (SPF 30+) 4. Follow-up appointments for monitoring

10. Mechanism of Action: 1. Radiation damages keloid cells' DNA 2. Inhibits collagen production 3. Reduces inflammation and scarring 4. Prevents keloid recurrence

11. Laser Treatment Parameters: 1. Wavelength: 585-1064 nm 2. Pulse duration: 1-50 ms 3. Fluence: 1-50 J/cm² 4. Spot size: 1-10 mm