Contemporary treatment of keloids: A 10-year institutional experience with medical management, surgical excision, and radiation therapy - 12/04/21
Abstract |
Introduction |
We evaluate a single center’s, decade-long experience utilizing 3 approaches to keloid treatment: corticosteroid medical management (MM), surgical excision (SE), and surgical excision + radiation therapy (SE + RT).
Study design |
Patients undergoing keloid treatment were identified (2008–2017). Outcomes were symptomatology/cosmesis for MM, and recurrence and complications for SE and SE + RT. Logistic regression was used to determine factors associated with recurrence and complications.
Results |
284 keloids (95 MM, 94 SE, 95 S E + RT) corresponded to patients with a median age of 39.1 (IQR: 26.1–53), 68.1% Black, and followed-up for 15.4 months (IQR: 5.6–30.7). For MM, 84.6% and 72.5% reported improvement in cosmesis and symptoms, respectively. SE and SE + RT recurrence were 37.2 and 37.9%, respectively. In adjusted analyses, higher radiation doses were associated with decreased recurrence whereas male gender (OR 3.3) and postoperative steroids (OR 9.5) were associated with increased recurrence (p < 0.01). There were more complications in the SE + RT group.
Conclusions |
MM resulted in at least some improvement. Recurrence rates after SE and SE + RT were similar. Female sex is protective, race does not affect outcomes.
Le texte complet de cet article est disponible en PDF.Highlights |
• | The majority of medically managed patients experienced at least some improvement in symptomatology and cosmesis. |
• | Surgical excision and surgical excision with radiotherapy had similar recurrence rates. |
• | Higher radiation doses were associated with decreased recurrence. |
• | Postoperative steroids (OR 9.5) and male sex (OR 3.3) were associated with increased recurrence. |
• | Keloid locations on an extremity (OR 19.5) and larger surface area (OR 1.0) were associated with increased complications. |
Keywords : Keloid, Corticosteroid, Surgery, Radiation, Recurrence, Complication
Abbreviations : MM, SE, SE+RT, IQR, OR, BED
Plan
Vol 221 - N° 4
P. 689-696 - avril 2021 Retour au numéro
Article précédent
- Commentary on “Comparative effectiveness in the treatment of keloids: Outcomes between medical management, surgical excision, and radiation therapy over 10 years.”
- Omar K. Danner
- Do male chairs of surgery have implicit gender bias in the residency application process?
- Sophie Dream, Meagan Mandabach Olivet, Lauren Tanner, Herbert Chen
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?