Plantar keloids

NewsBot · Mar 24, 2016

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Plantar keloids: diagnostic and therapeutic issues in six patients.
Vanhaecke C Jr et al
J Eur Acad Dermatol Venereol. 2015 Jul;29(7):1421-6.

BACKGROUND:
Keloids are benign fibro-proliferative skin lesions that very rarely occur on the soles. Because of their rarity, the diagnosis of plantar keloids can be difficult. We describe the clinical and histopathological characteristics of eight plantar keloids.
METHODS:
All patients presenting with plantar keloids between 2005 and 2012 in our Dermatology unit were retrospectively included. Diagnosis was definitely established by re-reading of pathological slides in all cases. Clinical characteristics, histopathological features, treatments given and their results were collected.
RESULTS:
Six patients were included. Five patients had a single plantar keloid and one had three lesions. They all were of African descent. Only one patient remembered of a previous injury at the site of the keloid. Three patients presented with associated extra-plantar keloids. In four patients, the diagnosis of keloid was not initially suspected clinically or histologically. Re-reading of the clinical photographs showed that the eight plantar keloids shared common morphological features, leading to a distinctive clinical picture, defined by a hardened lesion of rounded or polycyclic shape, with a pink surface crossed by keratotic furrows and the presence of a hyperkeratotic rim. Concerning pathological features, typical hyalinized collagen can be missing and deep fibrosis should not rule out the diagnosis of keloid. Intralesional injection of triamcinolone acetonide and orthopaedic shoes were useful. All patients who had surgical excision presented recurrence.
CONCLUSION:
The knowledge of the clinical features of plantar keloids is helpful to the diagnosis. There is no well-established treatment, but supportive measures are important.
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NewsBot · Feb 15, 2022

Combination of fractional carbon dioxide laser and topical triamcinolone vs intralesional triamcinolone for keloid treatment: A randomised clinical trial
Niti Tawaranurak,Pitchaya Pliensiri,Krongthong Tawaranurak
14 February 2022

To compare the therapeutic effect of fractional carbon dioxide (CO2) laser + topical triamcinolone (TA) with intralesional TA on keloids. Twenty-two participants were randomised into two groups: group A, treated with fractional CO2 laser + topical TA, and group B, treated with intralesional TA. The interventions were performed at every 4-week interval until the keloids were resolved or at the completion of 1 year. At each session, the scar volume, Vancouver Scar Scale (VSS) were assessed. Recurrence was observed for 1 year. The mean scar volumes and VSS scores were not significantly different between the two groups. After 1 year, the scar volume change in group B was greater than group A (86.5% vs 59.1%, P-value = .016). The mean VSS scores were significantly decreased in group A (8.0 ± 1.5 to 4.8 ± 1.6, P-value <.001) and group B (8.4 ± 0.8 to 4.8 ± 1.6, P-value <.001). The keloids were completely resolved in 63.6% and 72.7% of the patients, and recurrence was observed in 9.1% and 18.2% of the patients in groups A and B, respectively. The combination of fractional CO2 laser with topical TA was an alternative option for the treatment of keloids.
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Jase Morris · Feb 16, 2022

Gracias por la información.

NewsBot · Feb 16, 2024

Clinical efficacy of ablative laser combined with pulsed dye laser in the treatment of pathological scars: A systematic review and meta-analysis
Yuan Tian, Meijia Li, Rong Cheng, Jian Yuan, lijun Hao
30 January 2024

Objective
A systematic review and meta-analysis were conducted to evaluate the efficacy and safety of ablative laser combined with pulsed dye laser to treat pathological scars.

Methods
A systematic literature review was conducted to identify all blind, randomized, controlled trials of ablative laser and pulsed dye laser for treating pathological scars. The databases PubMed, Embase, and Cochrane were used. All research on ablative laser combined with PDL in treating pathological scars with ablative laser or no treatment as controls were included in the meta-analysis. The retrieved studies' reference lists were thoroughly examined.

Results
POSAS and VSS were used as evaluation criteria in seven studies involving 189 patients. Effect of combined laser group therapy (−1.259 95% confidence interval, −1.515 to −1.003; p < 0.0001). The difference between the combined treatment and control groups was (−1.375; 95% CI, −1.727 to −1.023; p < 0.0001) and (−1.150; 95% CI, −1.523 to −0.777; p < 0.0001).

Conclusions
Ablative laser combined with PDL is more effective and safer than ablative laser or PDL alone in the treatment of pathological scars.
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