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Background:
Keloids are dermal tumors that are due to increased production of collagen caused by abnormal and prolonged wound healing. The incidence of recurrence is extremely high if only conservative measures are used. This study was conducted to evaluate the feasibility and efficacy surgery and high dose rate brachytherapy as an adjuvant therap...
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Citations
... The radiation treatment should be administered within 2 days of surgery [474]. The recurrence rates of KD after excision alone (n = 28), post-excision external beam radiotherapy (EBR), and interstitial high-dose-rate brachytherapy were 44%, 19% and 23%, respectively [475]. When brachytherapy with Iridium 192 was performed after a maximum of 7 h following surgery, the recurrence rate was 23.6%. ...
Keloids (KD) and hypertrophic scars (HTS), which are quite raised and pigmented and have increased vascularization and cellularity, are formed due to the impaired healing process of cutaneous injuries in some individuals having family history and genetic factors. These scars decrease the quality of life (QOL) of patients greatly, due to the pain, itching, contracture, cosmetic problems, and so on, depending on the location of the scars. Treatment/prevention that will satisfy patients’ QOL is still under development. In this article, we review pharmacotherapy for treating KD and HTS, including the prevention of postsurgical recurrence (especially KD). Pharmacotherapy involves monotherapy using a single drug and combination pharmacotherapy using multiple drugs, where drugs are administered orally, topically and/or through intralesional injection. In addition, pharmacotherapy for KD/HTS is sometimes combined with surgical excision and/or with physical therapy such as cryotherapy, laser therapy, radiotherapy including brachytherapy, and silicone gel/sheeting. The results regarding the clinical effectiveness of each mono-pharmacotherapy for KD/HTS are not always consistent but rather scattered among researchers. Multimodal combination pharmacotherapy that targets multiple sites simultaneously is more effective than mono-pharmacotherapy. The literature was searched using PubMed, Google Scholar, and Online search engines.
... 9,10,22,24 Penyebab utama keloid adalah trauma atau cedera pada kulit yang dapat timbul dari berbagai peristiwa seperti tindakan operasi, tindik, peradangan, jerawat, pengikisan kulit, gigitan nyamuk atau serangga, luka bakar, tato, suntikan, bekas luka cacar air. 8,[11][12][13][14][15][16][17][18][19][20][21]23,[25][26][27] Beberapa literatur menyebutkan bahwa keloid juga dapat disebabkan oleh adanya infeksi kulit seperti folikulitis, dermatitis, dan furunkel, 37,41,51 serta adanya peranan dari genetik atau warisan keluarga. 12,18,19,26,27 Elektroporasi kalsium merupakan golongan pengobatan baru yang telah diselidiki untuk tumor kulit ganas. ...
Latar belakang. Penyembuhan luka yang patologis dan pembentukan bekas luka patologis menimbulkan kerugian fungsional dan estetika. Keloid adalah bekas luka berlebihan yang tumbuh melewati batas luka aslinya yang merupakan kelainan fibroproliferatif. Keloid sulit untuk diobati karena sifat keloid yang rekuren dan terapi terhadap keloid yang masih belum sempurna dapat menyebabkan keloid semakin parah. Berdasarkan uraian diatas, studi literatur ini dibuat oleh penulis untuk menjelaskan tentang penyebab dan penanganan terhadap keloid. Metode. Artikel penelitian yang ditinjau berupa analytical review melalui data basePubMed. Hasil. Sebanyak 20 artikel penelitian terpilih yang sesuai dengan tujuan penulisan tinjauan pustaka ini. Kesimpulan.Penyebab utama keloid adalah trauma, cedera ataupun infeksi pada kulit. Monoterapi untuk keloid tidak disarankan karena tingkat kekambuhannya lebih tinggi dibandingkan dengan terapi kombinasi. Beberapa modalitas untuk pengobatan keloid adalah prosedur bedah, radioterapi, antitumor/antikanker, elektroporasi kalsium, kortikosteroid, tekanan magnetik intermitten, gel silikon, laser, Plasma Skin Regeration, dan penggunaan cryotherapy. Eksisi merupakan modalitas terapi yang memberikan pengurangan ukuran keloid secara instan, namun karena rekurensinya tinggi maka harus diberikan terapi lain sebagai terapi kombinasi, yaitu injeksi kortikosteroid ataupun radioterapi yang dapat mengurangi tingkat kekambuhan pasca eksisi.
... Both scars are unattractive and linked to a decline in quality of life, physical condition, and mental health [4]. In the Indian community, 50 patients were diagnosed with 71 keloids, and 48% of those cases had ear keloids because ear piercing is a common custom there [5]. Keloids are equally common in both sexes, more common in persons with darker skin than in those with lighter pigmentation, and more common from the ages of 10 to 30. ...
Keloids are benign tumors that grow as a result of excessive collagen release from overexpressed fibroblasts. Keloids and hypertrophic scars are distinguished by the fact that keloids develop beyond the site of the original lesion, but hypertrophic scars do not. It is still unclear why this mechanism operates, mainly when aberrant scarring occurs. Despite several treatments' availability, the keloids' recurrence rate remains high. Here, we summarize recent narrative reviews, systematic reviews, and meta-analyses to give a general overview of the condition, its underlying causes, and available therapies for keloids. To undertake a comprehensive investigation of the disease, over 100 publications were reviewed utilizing Google Scholar and Pubmed. We also shed light on using phytochemicals as a natural alternative to prevent keloid scarring, which occurs when the body responds abnormally to external injuries by producing scar tissue. We also summarize the available current treatments.
Keloid is a common benign skin tumor in the outpatient department, and patients are often accompanied by itching and pain. Since the pathogenesis is unknown, the effect of single method treatment is unsatisfactory, and therefore the recurrence rate is high. Therefore, comprehensive treatment is mostly used in clinical treatment. Adjuvant radiotherapy is currently one of the most effective treatments for keloid. After long-term clinical practice, brachytherapy and electron beam radiotherapy has increasingly become the gold standard of treatment, because brachytherapy provides more focused radiation treatment to focal tissue to significantly reduce recurrence rate, and better preserve normal tissue. With the development of new radiotherapy techniques, more options for the treatment of keloid. Currently, adjuvant radiotherapy has been widely recognized, but there is no consensus on the optimal protocol for adjuvant radiotherapy for keloids. This review provides a review of published treatment options and new radiotherapy techniques for adjuvant radiotherapy of keloids and gives a comprehensive evaluation for clinical treatment.
