Different therapeutic modalities in a patient with multiple spontaneously developed keloids: a case report

Bukvić-Mokos, Zrinka and Lipozenčić, Jasna and Marinović, Branka (2006) Different therapeutic modalities in a patient with multiple spontaneously developed keloids: a case report. Collegium Antropologicum, 30 (4). pp. 941-944. ISSN 0350-6134

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Abstract

Keloids are benign tumors that usually develop as an excessive healing response to injury. They remain a challenging therapeutic problem to this day. Numerous treatment approaches are available, yet therapeutic results are often not satisfactory. A female patient with multiple spontaneously developed keloids on her trunk is presented. In this patient, four different therapeutic options were employed at different sites, with variable responses. The first option included cryotherapy, with poor effect. Slight flattening was observed after intralesional corticosteroid therapy. Treatment with excision followed by radiotherapy resulted in recurrence after 3 months. The best effect was noticed when excision and injection of corticosteroids into surgical margins were followed by radiotherapy. To the authors' knowledge, this is the first report of three-modal therapy in the management of keloids, which resulted in no recurrences over a 3-year follow-up.

Abstract in Croatian

Keloidi su dobroćudni tumori koji obično nastaju nakon ozljede, kao posljedica neprimjerenog tkivnog odgovora pri cijeljenju. Radi se o promjenama koje u današnje vrijeme još uvijek predstavljaju terapijski problem. Iako su na raspolaganju brojne terapijske mogućnosti, rezultati liječenja obično nisu zadovoljavajući. Opisuje se bolesnica s višestrukim, spontano nastalim keloidima na trupu. Četiri terapijska pristupa su primijenjena na različitim keloidima u iste bolesnice, s različitim terapijskim odgovorom. Krioterapija kao prvi terapijski pristup nije dovela do zadovoljavajućeg učinka. Intralezijskom primjenom kortikosteroida postignuta je djelomična regresija promjene. Keloid koji je liječen ekscizijom i potom radioterapijom ponovno se je pojavio nakon tri mjeseca. Najbolji rezultat je postignut kombinacijom ekscizije, intralezijske primjene kortikosteroida u rubove operacijskog reza i zatim radioterapije. Prema saznanjima autora, ovo je prvi opis trimodalnog terapijskog pristupa u liječenju keloida, nakon kojeg nije nastao recidiv tijekom trogodišnjeg praćenja bolesnice.

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