Earlobe Keloids: A Pilot Study of the Efficacy of Keloidectomy with Core Fillet Flap and Adjuvant Intralesional Corticosteroids

Abstract

Management of earlobe keloids is challenging because they are often resistant to treatment. The literature reports different treatment modalities with variable responses. Surgical excision with core fillet flap in combination with adjuvant intralesional steroid injection has not been thoroughly explored for keloid treatment, in spite of its positive therapeutic and cosmetic outcome. To evaluate the clinical efficacy of keloidectomy with core fillet flap and adjuvant intralesional steroid injection in treating earlobe keloids. Between 2004 and 2012, 21 earlobe keloids were treated using keloidectomy with core fillet flap and given intraoperative intralesional steroid injections. Follow-up was scheduled 2weeks after the procedure and then monthly to administer intralesional steroid injections and to assess response, postoperative complications, recurrence, and objective and subjective satisfaction. The clinical outcome efficacy was 87.6%. Mean follow-up was 21.9months. Immediate recurrence was 9.5%, with few complications encountered. Subjectively, 82.3% of the patients were highly satisfied. Keloidectomy with core fillet flap and adjuvant intralesional steroid therapy is an effective modality for the clinical management of earlobe keloids. This approach should be considered for the treatment of this difficult condition.