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Keloid, Nodular, or Keloid-Like Morphea Scleroderma

Overview: What are Keloids?
Causes of Keloids
Diagnosis of Keloidal Scleroderma
Treatments for Keloids
Personal Stories

Overview: What are Keloids?

Keloids are smooth, shiny, flesh-colored, raised growths of fibrous tissue that form over areas of injury or surgical wounds. Keloids may form in any scar, even those resulting from severe acne. They are much more common in blacks than in whites and typically develop on the chest, shoulders, back, and, sometimes, face and earlobes. Keloids do not hurt, but they may itch or be sensitive to touch. Merck Manual.

Causes of Keloids

Keloids: Epidemiology. Individuals of all ethnic backgrounds can form keloids and hypertrophic scars. Prevalence in the black and Hispanic populations can be as high as 16%, and a familial predisposition is believed to exist. Keloid formation is approximately 15 times greater in highly pigmented ethnic groups than in whites. eMedicine.
Keloids and Hypertrophic Scars. It is not known why keloids appear. While most people never form keloids, others develop them after minor injuries, even insect bites or pimples. Keloids may form on any part of the body, although the upper chest and shoulders are especially prone to them. Dark skinned people form keloids more easily than Caucasians. DermNet NZ.

Diagnosis of Keloid Morphea or Keloid-Like Scleroderma

Sometimes keloids occur in patients who have scleroderma, and in particular they are more likely to occur in patients with systemic scleroderma. The terms "keloidal" or "nodular" scleroderma are used interchangeably. (See: What is Scleroderma?)
In one study, keloidal or nodular scleroderma occurred in 6 out of 45 patients with systemic scleroderma. All of the patients with keloidal or nodular scleroderma also had systemic scleroderma, so the presence of keloids in a patient with symptoms of scleroderma should alert the physician to the possibility of systemic scleroderma (not just morphea, as the term "keloid morphea" seems to imply.)
(Includes Photos) Keloids in scleroderma-keloidal scleroderma: A unique entity. Scleroderma with multiple keloids is a rare finding. The morphology of these lesions often does not correlate with the histologic findings. Indian J Dermatol 2013;58:153-4.

Treatments for Keloids

Keloids: Treatment. The treatment of keloids can be subdivided into surgical, nonsurgical, and combined modality treatment. Many published reports advocate a variety of therapies; however, few studies provide a coherent therapeutic plan because of poorly defined endpoints in treatment, inadequate follow-up care, failure to properly distinguish between hypertrophic scars and keloids, and lack of prospective studies. Most of the literature on keloids suggests that a high recurrence rate (50%) is expected, regardless of treatment.

Personal Stories about Keloids and Keloidal Scleroderma

Submit your personal story about Keloidal or Nodular Scleroderma.
Bwana: Keloids The keloids have spread all over my face, back, chest, arms and legs...
Joshua: Morphea My morphea doesn't look like most. In fact, it looks almost star-shape, mostly because it is in lines and not a solid shape. It is not hard either, so my fear is that it could be keloid morphea...
Tina M: Keloids My husband calls them my battle scars or unfinished tattoos...
 
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