Crabby Keloids

Keloid comes from Greek cheloides = Crab's Claws.

Risks:

• Dark pigmentation
• Familial
• Race: Black, Hispanic, Asian
• Young (peak 10-20)
• Hormonal
• Burns

• Prevention in the predisposed
  Silicone elastomer sheets
• CCS injection
• Taping

Treatment:

• Same as prevention
• Cryotherapy for small lesions (caution: hypopigmentation in dark-skin)
• Pulsed dye laser

CCS:
Triamcinolone intralesionally plus or minus pretx with cryo
Space tx over several mos.

Sheets:
12-24 hours per day / 2-3 mos after open wound has healed
Pressure dressing alternative esp. burns

Novel:

• Imoquimod QO HS for 8 weeks
• 5 FU
• Bleomycin tattoo
• Alpha-interferon

Discourage:

• Vitamin E: contact dermatitis, impaired tensile strength
• Medera