Abstract
BackgroundKeloids 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.MethodsPatients 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.ResultsOf 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.ConclusionsWe successfully treated foot keloids using complete surgical excision and full thickness skin grafting followed by four corticosteroid injections (at one month intervals).
Highlights
The proliferation of normal tissue healing processes results in keloid scarring that enlarges well beyond the original wound margins [1]
Patients with foot keloids admitted to our institution for surgical therapy were included in the present study based on several criteria: 1) the presence of clinically definite keloid scars on the foot dorsum; 2) scheduled for a complete surgical excision with full thickness skin grafting; 3) the patient can understand and comply with adjuvant corticosteroid injection therapy
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
Summary
The proliferation of normal tissue healing processes results in keloid scarring that enlarges well beyond the original wound margins [1]. Some of the common characteristics of foot keloids are central sparing (Figure 1) and ulceration (Figure 2). They typically cause secondary infections, contracture, and limited range of motion, which leads to severe functional problems. To the best of the authors’ knowledge, 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
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