Keloid scars are divided into physiological and pathological keloid scars. Flat keloid scars formed after normal wound healing are called physiological keloid scars, and hyperplastic raised keloid scars formed by abnormal healing are called pathological keloid scars, including hyperplastic keloid scars and keloids.
Keloid scars are an ancient disease. As early as the 13th century, keloid scars were described in the sculptural paintings of the Yoruba people in Western Nigeria. In recent years, people have conducted a lot of research on them from multiple perspectives, such as molecular biology, genetics, histology, and immunology, and have gained a better understanding of keloid scars, but the mechanism of their formation has not been revealed so far, and keloid scars seem to be a long and eternal puzzle.
The occurrence of keloid scars: The incidence of keloid scars in the population is not known, but it is now accepted that keloid scars have a tendency to be race-specific, site-sensitive, and familially inherited.
Genetic background of keloids: The majority of keloids are disseminated cases, but some have a genetic predisposition.
Causes of keloid initiation: The first cause of keloid is often unclear, and can be triggered by inflammation, trauma, vaccination, mosquito bites, surgery, etc. It can be divided into primary, secondary, and transitional types. The findings of our cases are: trauma and puncture are the main triggering factors, and all keloids on the earlobe are caused by puncture, but in 7 cases, the earlobe was punctured bilaterally and only one side formed a keloid, one of which was infected after the puncture on the right side, forming a scar that spread behind the ear and neck and affected the neck activity; the triggering factors of the chest scar are mostly small unnoticed breaks, such as mosquito bites and insect bites, and scratching. A significant portion of keloids are triggered by the continuous secretion of sebaceous glands within the keloid, which continuously stimulates the enlargement of the scar; it is worth noting that surgery is the second cause of keloids.
Keloid scars have certain prevalent sites. It is generally believed that the chest, deltoid region, scapular region, upper back, lower extremities, upper limbs, abdomen, earlobes, and jaw are prevalent, while keloid scars on eyelids, forehead, lower back, external genitalia, palms, feet, cornea, mucosal tissues, and umbilical cord are of low incidence. The most prevalent site in this group of cases is the chest, followed by earlobes and shoulders. The keloid scars on the chest and shoulder may be related to the high local skin tension and shoulder joint activities; for keloid scars occurring in uncommon areas, they must be handled with caution.
Treatment of keloid scars: So far, there is no ideal treatment for keloid scars because the mechanism of occurrence is unknown. The current treatment methods are: intra-scar drug injection; compression therapy; surgical excision with adjuvant radiation therapy, etc.