Keloid cicatrixes
Contents:
Description:
Keloid (keloid cicatrix) — (from Greek kele — a tumor and éidos — a look), tumorous growth of rough fibrous connecting tissue of skin.
Symptoms of Keloid cicatrixes:
Distinguish a keloid true (spontaneous), arising on probably not changed skin, and the false keloid developing on site a hem after an injury (mechanical, thermal, chemical, etc.) or a purulent disease (for example, a furuncle). Its growth usually begins in 1-3 months after wound epithelization Typically lack of parallelism between weight of an injury and expressiveness of keloid cicatrixes, they can arise even after insignificant damages (a prick, sting) and often after a burn of IIIA of degree. A true keloid — a little towering (5 — 8 mm) over the surface of skin of whitish or pinkish color education, a dense consistence, with a smooth brilliant surface. At a histologic research find the extended gyrose bunches eozinofilno of the painted hyalinized collagen, thinning of nipples of a derma and decrease in elasticity of fibers. Makes a morphological basis of a keloid the growing unripe connecting fabric with a large number of atypical huge fibroblasts, the long time being in functionally active state is excessive. In keloids there are not enough capillaries, corpulent and plasmocytes. Growth happens within several weeks, sometimes months then the sizes a keloid do not change until the end of the patient's life. Stabilization of a condition of a keloid cicatrix usually occurs in 2 years after its emergence. It is characteristic that keloid cicatrixes practically never ulcerate.
Reasons of Keloid cicatrixes:
Origins of keloids are not clear. Individuals have a predisposition to development of keloids.
Risk factors:
* The expressed xanthopathy
* Certain localization of initial damages (area of a deltoid muscle, thorax, ear lobe)
* Pregnancy
* Pubertal period.
Treatment of Keloid cicatrixes:
According to "The international recommendations about maintaining patients with pathological hems" there are only two methods of treatment of hems which efficiency is confirmed in controlled randomized researches:
* use of silicone gel / covering
* injections of corticosteroids to the area of a hem
Other methods of treatment:
* Surgical excision.
* Radiation therapy.
* Compression (pressure).
* Ointment therapy
* Laser processing
* Cryotherapy
Example of treatment by means of an injection of corticosteroids:
Choice drug — Triamcinolonum acetonide in the form of the suspension containing 10 mg/ml — injections to the area of a hem. Efficiency of a method is higher at fresh keloid cicatrixes. Treatment is repeated in each 4 weeks before comparison of hems with the surface of skin. In the absence of effect it is possible to apply Triamcinolonum suspension containing 40 mg/ml. At surgical excision of keloids it is possible to apply Triamcinolonum solution mix (5-10 mg/ml) with mestnoanesteziruyushchy means. For prevention of a recurrence after operation — a glucocorticoid injection to the area of a cicatrectomy in 2-4 weeks and then 1 р / month within 6 months. Under the influence of Triamcinolonum keloids decrease in 6-12 months, leaving flat light scars.
