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Keloid in Adult
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Keloid in Adult

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Contributors: Lynn McKinley-Grant MD, Belinda Tan MD, PhD, Lowell A. Goldsmith MD, MPH
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Synopsis

Keloids are dense, fibrous tissue nodules typically found at areas of previously traumatized skin (eg, burns, lacerations, incision scars), or arising spontaneously on normal skin. Lesions may be single or multiple. Over weeks to months, these large nodules can become painful, tender, pruritic, and grow to become very large (up to 30 cm). They can cause chronic discomfort, be disfiguring, and restrict normal tissue motion. Most patients start developing keloids in their 20s.

Keloids are most frequent in individuals of African descent and those of Mediterranean ancestry, but they can appear in any race or ethnicity. People with darker skin phototypes have a significantly higher tendency to form keloids, with an incidence as high as 16% in black Africans. There is likely a genetic basis for the tendency to develop keloids.

A distinction should be made between a keloid and a hypertrophic scar. All trauma that involves the dermis will heal with a scar; however, in certain individuals, the scar is much larger and thicker than what is considered normal. These lesions are termed hypertrophic scars. In contrast to keloids, hypertrophic scars are always preceded by trauma and are always confined to the margin of the wound. Hypertrophic scars also appear immediately after trauma and show a tendency to gradually regress, whereas keloids can be delayed in appearance and are thought to very rarely spontaneously resolve.

For more information, see OMIM.

Codes

ICD10CM:
L91.0 – Hypertrophic scar

SNOMEDCT:
33659008 – Keloid scar

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Last Updated: 10/30/2018
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Keloid in Adult
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Keloid : Earlobe, Shoulder, Superior chest, Upper back, Raised scar, Smooth nodules
Clinical image of Keloid
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