(Disclaimer: This article is for scientific use only, and relevant information in the following content has been processed to protect Ms. Li’s privacy)
Abstract: The subject of this case is 30-year-old Ms. Li, who was seen at our hospital 2 years after her cesarean delivery with significant keloid scars at the incision site and a tendency to grow outward, with significant itching and occasional mild pain, which seriously affected her quality of life and appearance. After treatment, the skin surface keloid gradually shrank, the color gradually faded, and the local itching and pain were relieved.
Basic information】Female, 30 years old
Disease Type】Keloid
Hospital】Harbin Hospital of Traditional Chinese Medicine
Date of Consultation】February 2022
Treatment plan] Closed injection (compound betamethasone injection, lidocaine hydrochloride injection)
Treatment period】4-6 months for outpatient treatment
【Treatment effect】The skin surface keloid gradually shrunk, the color gradually faded, local itching and pain relief
I. Initial consultation
Ms. Li described: 2 years after her delivery, her original cesarean section site had formed obvious keloid scars, which tended to grow outward, with significant local itching and occasional mild pain, seriously affecting her quality of life and appearance. On examination, Ms. Li had a long strip of red hyperplastic keloid in her lower abdomen, with a length of about 20 cm and a projection of 0.5 cm, with a smooth surface but varying thickness. Ms. Li’s medical history was clear, and no clinical auxiliary examination was needed to diagnose keloid.
(Body check)
II. Treatment history
After communicating with Ms. Li, the treatment plan was clarified, and compound betamethasone injection was chosen to treat the keloid by performing closed injection. Using the immunosuppressive and atrophic effects of glucocorticoids, the keloid on the abdomen gradually became lighter and faded in color to achieve the therapeutic effect. During the injection, the iodophor solution was disinfected twice, and the compound betamethasone injection + lidocaine hydrochloride injection was mixed thoroughly before the closed injection, and after the local skin surface was whitened, the next point was injected, and a total of 10 points were injected in the whole scar. Ms. Li said that the operation was moderately painful, followed by local iodophor disinfection, and she was instructed to follow up regularly and have the second treatment after 1 month.
(After closure)
III. Treatment effect
Ms. Li followed up in the outpatient clinic after 1 month of treatment and checked: the color of the bright red scar proliferation tissue on the skin surface became slightly darker and appeared light brown, the proliferative scar became significantly lighter, the bump shrank from the original 0.5cm to about 0.3cm, and the length was slightly shortened. In addition, Ms. Li self-reported that the itching and pain of the local keloid was slightly relieved, and she was instructed to continue the periodic treatment.
IV. Notes
I am glad that after the treatment, Ms. Li’s keloid is gradually shrinking and the itching and pain are gradually relieved. Keloid is related to individual’s constitution, and if frictional stimulation occurs after the formation of keloid, it may lead to keloid hyperplasia, so do not rub the keloid repeatedly during treatment. If redness, swelling and pain occur at the injection site, combined bacterial infections are considered, and it is recommended to choose to use antibiotic drugs for targeted treatment. If local ulceration occurs during the injection period, you should return to the hospital promptly.
V. Personal insight
Keloid scars are hyperpigmented, fibrous, pink or red redundant organisms that pathologically appear mainly as dense and well-defined nodular neoplasms composed of myofibroblasts resembling proliferative swirling arrangements in the dermis, and collagen.
It is mostly a residual mark due to cuts, lacerations, and burns. Most keloid scars are found on the upper chest, back, etc., but in some people they may appear on the extremities or abdomen in the form of crab feet extending outward. Clinically, the treatment can be either closed with glucocorticoid injections or surgical excision followed by isotope radiation therapy.