Recurrence Bilateral Auricular Keloids: Successful Combined Treatment after Two Years Follow-up. Case Report

Abstract

Background: Keloids represent an aberrant, poorly understood response during wound healing. Management is still controversial. Especially when located on exposed parts of the body, keloids can seriously affect a person’s appearance and self esteem. Many different treatment modalities may be used for keloids. However, no single method alone has been found to be completely successful. Therefore, the authors decided to combine three different techniques to improve and/or resolve a recurrent case of bilateral auricular keloids. Methods: A 49-year-old male with recurrent and symptomatic bilateral great auricular keloids was treated. Bilateral keloid excision coupled with auricular anatomy reconstruction using local flaps and grafts was performed. Two hours after surgery, superficial radiation therapy started consisting of ten sessions performed daily using a 150-centigray (cGy) dose per session on each ear for a total dose of 1500 cGy on both sides at the surgical sites. After the first month post radiation therapy, 10 monthly sessions involving infiltration over the auricular scars with corticosteroids and 5- fluorouracil were performed. Result: After 2 years of follow-up, the treatment proved to be a complete aesthetic solution with no further symptoms or recurrence of the keloids. No side effects or other complications were observed. Conclusion: The authors propose that the combination of reconstructive surgery following radiation therapy and infiltration with corticosteroids and 5-fluorouracil is a solution for recurrent auricular keloids.