Abstract
ABSTRACTKeloid following circumcision has been described in the literature despite the rarity of its occurrence in penile skin. In this paper, we review the literature and report the successful management of post-circumcision keloid scarring in a 2-year-old boy. After circumcision a 2-year-old boy of African origin developed keloid scarring at the circumcision site. This was treated with three intralesional injections of triamcinolone acetate over 3 months, followed by surgical excision. There was no recurrence at 6 months after excision. To our knowledge this is the 12th case of keloid following paediatric circumcision described in the literature. There is a wide range of techniques described but all are recurrence free at 6 months following repeated intralesional triamcinolone acetate injection and surgical excision. While there is no current consensus in treating post-circumcision keloid, we find that intralesional injection followed by surgical excision provides an acceptable aesthetic result, which is recurrence free.
Highlights
Keloid scars result from an interrupted wound healing process and as such form a raised, red scar extending beyond the original wound to invade healthy skin
The least common sites are the feet and penile skin; to our knowledge there have been 11 cases of penile keloid described in the paediatric literature following circumcision
In the case described above, we found a scar that extended beyond the original circumcision site, which was raised and had keloid features on pathology
Summary
Keloid scars result from an interrupted wound healing process and as such form a raised, red scar extending beyond the original wound to invade healthy skin They are typically described as occurring in the upper chest, shoulders, upper back, and the head and neck. As well as causing a poor aesthetic outcome, keloid scarring in this location can lead to functional disturbance This is the case if there is circumferential involvement of the circumcision site or if the scar has extended to entirely cover the glans. Around 7 months later he was referred to the paediatric surgery team by the GP with keloid scarring of the penile skin (Figure 1) This was initially treated with 1% hydrocortisone cream topically before starting a series of triamcinolone acetate injections. The patient was discharged home on the same day and followed-up at 2 and 6 months in clinic with no recurrence and a satisfactory aesthetic result (Figure 3)
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