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. 2013 Jul 15:6:26.
doi: 10.1186/1757-1146-6-26. eCollection 2013.

Clinical features and outcomes of foot keloids treated using complete surgical excision and full thickness skin grafting followed by corticosteroid injections

Tae Hwan Park #  1   2 , Ji Hae Park #  1 , Choong Hyun Chang  1
Affiliations

Clinical features and outcomes of foot keloids treated using complete surgical excision and full thickness skin grafting followed by corticosteroid injections

Tae Hwan Park et al. J Foot Ankle Res. .

Abstract

Background: Keloids are often resistant to treatment and have high recurrence rates. To the best of the authors' knowledge, however, there have been very few case reports related to foot keloids. The purpose of this retrospective case-series was to summarize the baseline characteristics of a cohort of patients, introduce our treatment regimen for the successful treatment of foot keloids.

Methods: Patients were treated with surgical excision followed by full thickness skin grafting combined with postoperative steroid injections combined with silicone gel sheeting over a period of eight years from December 2004 to November 2012 at our institution. Subjective outcome was evaluated using Patient Scar Assessment Scales. The final objective outcome was judged by two independent physicians at the time of 12 months after treatment as recurrence or non-recurrence.

Results: Of 79 patients, 75 (94.9%) were women and 4 (5.1%) were men. The average age was 18 (range 7-43) years. The average pretreatment total size of the lesions was 50 (range 18-150) cm. The number of patients treated for a primary foot keloid was 29 (36.7%), and 70 patients (63.3%) were treated for a recurrent keloid that failed to respond to prior treatments. Prior treatments included single therapies such as surgical excision alone (4 patients, 5.1%), prior steroid injection alone (33 patients, 41.8%), and laser therapy (2 patients, 2.5%). Other therapies included combination treatments (11 patients, 13.9%). Most patients reported improved Patient Scar Assessment Scale by lapse of time. All patients completed the treatment regimen and follow-up of 12 months. Of these patients, 62 patients (78.5%) achieved successful treatment, while the remaining 17 (21.5%) experienced recurrence.

Conclusions: We successfully treated foot keloids using complete surgical excision and full thickness skin grafting followed by four corticosteroid injections (at one month intervals).

Keywords: Foot; Keloid; Recurrence; Steroid.

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Figures

Figure 1
Figure 1
Central sparing in a foot keloid.
Figure 2
Figure 2
Typical ulceration in a foot keloid.
Figure 3
Figure 3
Preoperative appearance of a patient.
Figure 4
Figure 4
Approximation of the harvested full thickness skin to the defect area using silk 2-0 sutures.
Figure 5
Figure 5
Postoperative 2 months.
Figure 6
Figure 6
Postoperative 12 months.
Figure 7
Figure 7
A representative shape of the defect following complete excision that could not be closed primarily.
Figure 8
Figure 8
Improved “patient scar assessment scale” by lapse of time.
Figure 9
Figure 9
Improved “itchiness” by lapse of time.
See this image and copyright information in PMC

References

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