Funktionelle und ästhetische Behandlung von Keloiden

Zusammenfassung

Keloide sind das Ergebnis einer Dysbalance zwischen Reparation und Degradation der Extrazellulärmatrix als Bestandteil der Wundheilung. Sie wachsen tumorähnlich infiltrativ über den ursprünglichen Läsionsrand hinaus und können durch teils groteske Morphologien und damit kosmetische Entstellung für den Patienten eine soziale Stigmatisierung und einen erheblichen Leidensdruck darstellen. Brennen und quälender Juckreiz sind Teil der klinischen Symptomatologie der Keloidnarben.

Die therapeutische Polypragmasie, die in der Literatur zur Behandlung des Keloids beschrieben wird (u. a. Silikontherapie, Kompressionstherapie, Applikation von Kortikosteroiden, intra- oder extraläsionale chirurgische Exzision, Kryochirurgie, Radiatio), weist auf die enorme Herausforderung für den behandelnden Arzt, insbesondere im Bereich der plastischen Gesichtschirurgie, hin.

Abstract

Keloids are the result of a dysbalance between repair and degradation of the extracellular matrix as a component of woundhealing. They grow bulging excessively over the original scar edges and adopt sometimes bizarre morphologies. Patients can suffer from aesthetic defacement leading to social stigmatization and psychological strain. Dysaesthesia, burning pain and severe itching are elements of the clinical symptomatology of keloids.

The therapeutical polypragmasia described in literature as treatment for keloids (including silicon therapy, compression, intralesional corticoids, intra- and extralesional surgical excision, cryotherapy, lasertherapy, radiatio) emphasizes the enormous challenge for the treating doctor, particularly in facial plastic surgery.

• Literatur

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