Abstract
Keloids are benign, fibroproliferative growths that occur as a result of dermal injury
in ~15% of the population. They are characterized by their extension beyond the confines
of the original injury and often present with pain and pruritus. Additionally, these
growths may result in cosmetic deformities and contribute to significant emotional
distress. It is thought that keloids form as a result of aberrancies in the normal
wound-healing process, which is complex and involves an elegant interplay between
multiple cell types, cytokines, and proteins. The exact etiology is unknown, but significant
research efforts have been made. These efforts have revealed that various cell types
in keloids are either hyperresponsive and/or overproductive of various growth factors.
Additionally, keloid cell types respond differently to mechanical strain than skin
cells in patients who do not form keloids. This lack of understanding of keloid pathophysiology
has left the care provider with a lack of a single definitive treatment strategy.
Instead, a multitude of therapies exist ranging from surgery to injectables to lasers
and any combination thereof. This purpose of this article is to highlight our current
knowledge and emerging scientific understanding of keloid pathology and the current
management strategies.
Keywords
keloid - hypertrophic scars - treatment - scar
