Earlobe Keloids Research Articles

Surgery and Perioperative Intralesional Corticosteroid Injection for Treating Earlobe Keloids: A Korean Experience

The aesthetic implications of ear keloids, which affect people of all races, are serious and the treatment of earlobe keloids is known to be difficult. The high rate of recurrence following excision alone has led to investigating various types of adjuvant therapy, including intralesional corticosteroid injection. We evaluated the efficacy of excision combined with perioperative intralesional triamcinolone acetonide injection for treating earlobe keloids of Korean patients. From 1997 to 2006, eighteen keloids on the earlobes of fifteen Korean patients were treated. The patient age ranged from 15 to 32 years (mean age: 24 years). All the patients were female and the keloids occurred after ear piercing. Preoperative intralesional triamcinolone acetonide (TA) injection was administered twice at a 1-month interval. Postoperative intralesional TA injections were given every 1 month for several months, depending on the patient's clinical progress. The follow-up period ranged from 4 to 42 months (mean: 18.5 months). After the surgery, TA intralesional injections were given 2 to 13 times (mean: 5.2 times). Of the treated keloids, eleven showed good results (61.1%) and three recurred (16.6%). No complications from the TA intralesional injection were observed. Among the various treatments for earlobe keloids, we suggest that excision with corticosteroid intralesional injection can be used as the first line therapy when considering its effect and economic advantage.

Successful treatment of earlobe keloids in the pediatric population

Background Keloid scars present a difficult treatment challenge. Recently, intralesional steroid injection has become a common treatment modality [Akoz et al. Aesthetic Plast Surg. 2002;6:184-188; Studdiford et al. JABFM. 2008;21:149-152]. Although this has become a proven treatment technique, there is no standard injection protocol to which treating physicians commonly adhere. We hypothesize that timing of steroid injection may improve outcomes using this treatment technique in combination with lesion excision. Methods Fifteen patients with 16 earlobe keloids were treated using a standard steroid injection protocol with Kenalog (Bristol-Myers Squibb, New York, NY), in combination with lesion excision. Strict follow-up was enforced, with repeat injections as needed at any sign of abnormal scar formation postoperatively. Results Of 16 lesions, 15 (94%) were treated successfully with no sign of lesion recurrence at 6 months of follow-up. A single lesion was lost to follow-up and presented 18 months postoperatively with recurrence. This lesion was subsequently retreated successfully. Conclusions Kenalog injection in combination with excision is a well-tolerated and effective treatment of earlobe keloids in the pediatric population. We feel that timing of injection and adherence to a strict follow-up regimen is crucial to success.

Treatment of Recurrent Earlobe Keloids with Surgery and High-Dose-Rate Brachytherapy

Treatment of Recurrent Earlobe Keloids with Surgery and High-Dose-Rate Brachytherapy

Steroid After Surgery Prevents Recurrence of Earlobe Keloids

Steroid After Surgery Prevents Recurrence of Earlobe Keloids

TGF-beta1 Targeting on MMP—Expression in Keloid Fibroblasts

Problem Transforming growth factor-beta1 (TGF-beta1) has been identified as an important regulator of wound healing. Recent developments in molecular therapy offer exciting prospects for the modulation of wound healing, specifically those targeting TGF-beta1. The purpose of this study was to analyze the effect of TGF-beta1 targeting on the expression of matrix metallo-proteinases (MMP-2 and MMP-9) in fibroblasts cultured from earlobe keloids. Methods The expression of MMP-2 and MMP-9 in tissue samples from keloids was investigated by immunohistochemistry. The effect of TGF-beta1 targeting using antisense oligonucleotides on the expression of MMPs in keloid-derived fibroblasts was analyzed by ELISA and multiplex RT-PCR. Results Immunohistochemical studies demonstrated an increased expression of MMP-2 and MMP-9 proteins in tissue samples from keloids compared to normal human skin. The treatment of human keloid-derived fibroblasts with TGF-beta1 antisense oligonucleotides (ONDs) in vitro efficiently down-regulated MMP-9 expression but not the MMP-2 expression. In the supernatans of keloid-derived fibroblasts, the TGF-beta1 antisense therapy showed a decreased secretion level of both MMP-9 and MMP-2. So other than in MMP-9, the synthesis of MMP-2 does not seem to be influenced by TGF-beta1 anti-sense ONDs whereas the secretion of MMP-2, similar to that of MMP-9, is significantly decreased in the supernatans of keloid-derived fibroblasts. Conclusion TGF-beta1 antisense OND technology may be a potential therapeutic option for the inhibition of proteolytic tissue destruction in keloids. The results should be regarded as a further implication for the possible treatment of keloids. Significance The results should be regarded as a further implication for the possible treatment of keloids.

TGF-β1 antisense therapy modulates expression of matrix metalloproteinases in keloid-derived fibroblasts

Transforming growth factor-beta1 (TGF-beta1) has been identified as an important regulator of wound healing. Recent developments in molecular therapy offer exciting prospects for the modulation of wound healing, specifically those targeting TGF-beta1. The purpose of this study was to analyze the effect of TGF-beta1 targeting on the expression of matrix metalloproteinases (MMPs) in fibroblasts cultured from earlobe keloids. The expression of MMP-2 and -9 in tissue samples from keloids was investigated by immunohistochemistry. The effect of TGF-beta1 targeting using antisense oligonucleotides on the expression of MMPs in keloid-derived fibroblasts was analysed by ELISA and multiplex RT-PCR. Immunohistochemical studies demonstrated an increased expression of MMP protein in tissue samples from keloids compared to normal human skin. Antisense TGF-beta1 oligonucleotide treatment significantly downregulated MMP-9 secretion in vitro. In conclusion, TGF-beta1 antisense oligonucleotide technology may be a potential therapeutic option for the inhibition of proteolytic tissue destruction in keloids.

Prefabricated pressure earring for earlobe keloids

Keloid formation is a known complication of earlobe piercing. 1 Sela M Taicher S Prosthetic treatment of earlobe keloids. J Prosthet Dent. 1984; 52: 417-418 Abstract Full Text PDF PubMed Scopus (20) Google Scholar Keloids are essentially slow-growing neoplasms 2 Stashower ME Successful treatment of earlobe keloids with imiquimod after tangential shave excision. Dermatol Surg. 2006; 32: 380-386 Crossref PubMed Scopus (72) Google Scholar that grow past the borders of the original wound and are histologically characterized by abundance of fibroblasts, thick collagen bundles, and ground substance. 3 Yencha MW Oberman JP Combined therapy in the treatment of auricular keloids. Ear Nose Throat J. 2006; 85 (96-7.): :93-:94 PubMed Google Scholar Keloid formation is more prevalent among African and Asian ethnic groups than among whites 4 Akoz T Gideroglu K Akan M Combination of different techniques for the treatment of earlobe keloids. Aesthetic Plast Surg. 2002; 26: 184-188 Crossref PubMed Scopus (32) Google Scholar ; however, the exact incidence is unknown. 5 Vachiramon A Bamber MA A U-loop pressure clip for earlobe keloid. J Prosthet Dent. 2004; 92: 389-391 Abstract Full Text Full Text PDF PubMed Scopus (22) Google Scholar

Treatment of Recurrent Earlobe Keloids with Surgery and High-Dose-Rate Brachytherapy

Treatment of Recurrent Earlobe Keloids with Surgery and High-Dose-Rate Brachytherapy

Intraoperative Repiercing for Earlobe Keloid

Intraoperative Repiercing for Earlobe Keloid

Successful Treatment of Earlobe Keloids with Imiquimod after Tangential Shave Excision

Successful Treatment of Earlobe Keloids with Imiquimod after Tangential Shave Excision

P91: Treatment of Recurrent Earlobe Keloids with Surgery and High-Dose-Rate Brachytherapy

Arneja, Jugpal S. MD; Singh, G Balbir MD; Dolynchuk, Kenneth N. MD; Murray, Kenneth A. MD; Rozzelle, Arlene A. MD; Jones, Keith D. MD

Successful Treatment of Earlobe Keloids with Imiquimod after Tangential Shave Excision

The treatment of earlobe keloids has historically been suboptimal; characterized by discomfort, poor response, and high rates of recurrence. Keloids are characterized by increased fibroblast activity in the setting of an altered cytokine profile. To investigate whether topical imiquimod 5% cream applied postoperatively after tangential excision can prevent recurrence of earlobe keloids. Four patients with a total of eight large pedunculated earlobe keloids (five of which were recurrent lesions) were treated with debulking by tangential shave excision followed by daily application of imiquimod 5% cream for 6 weeks. At 6 and 12 months post-treatment there was an excellent cosmetic result and no evidence of recurrence in any of the lesions. Patients with keloids that were itchy and painful were completely asymptomatic at the conclusion of the study. In this pilot study, imiquimod 5% cream following tangential shave excision was efficacious for the treatment of earlobe keloids. Further study is warranted to confirm the utility of imiquimod 5% cream in the treatment of earlobe keloids, as illustrated herein.

Successful Treatment of Earlobe Keloids with Imiquimod after Tangential Shave Excision

Successful Treatment of Earlobe Keloids with Imiquimod after Tangential Shave Excision

Combined Therapy in the Treatment of Auricular Keloids

Management of earlobe keloids is still controversial. Many different treatment modalities have been employed; however, no single approach has been completely successful. We used combination therapy that included compression therapy, laser excision, and serial steroid injection, which has improved our therapeutic outcomes for earlobe keloids.

Postsurgical Use of Imiquimod 5% Cream in the Prevention of Earlobe Keloid Recurrences: Results of an Open-Label, Pilot Study

Postsurgical Use of Imiquimod 5% Cream in the Prevention of Earlobe Keloid Recurrences: Results of an Open-Label, Pilot Study

Treatment of Earlobe Keloids Using the Cobalt 60 Teletherapy Unit

Treatment of Earlobe Keloids Using the Cobalt 60 Teletherapy Unit

Cryosurgery in the Treatment of Earlobe Keloids: Report of Seven Cases

Keloids are benign cutaneous lesions that result from excessive collagen synthesis and deposition. Earlobe keloids in particular are seen as a complication of plastic surgery or piercing. Many different treatment modalities have been used, often with unsatisfactory results. We have made a retrospective analysis of seven young patients (ages 9 to 22 years) with earlobe keloids. Scarring followed plastic surgery in six cases and piercing in one case. All patients were treated with cryosurgery as the monotherapy. The freeze time and the number of sessions varied depending on the clinical findings, the effect of the treatment, and the patients' tolerance. Cryotherapy was started 6 to 24 months after keloid development. Scar volume was reduced in all cases. Complete flattening in five patients and a pronounced reduction to a maximum of 25% of the previous thickness in one other patient were achieved. One patient discontinued the therapy because of soreness after only partial improvement. The procedure was painful for all patients; no further side effects were noticed. No recurrence was observed within 1 to 4.5 years of follow-up. We present an excellent effect of cryosurgery as the monotherapy for the treatment of earlobe keloid scars of young patients.

Cryosurgery in the Treatment of Earlobe Keloids

Cryosurgery in the Treatment of Earlobe Keloids

Postsurgical Use of Imiquimod 5% Cream in the Prevention of Earlobe Keloid Recurrences: Results of an Open-Label, Pilot Study

Traditional surgical modalities for the management of earlobe keloids are often associated with high recurrence rates. A recent report suggests that imiquimod 5% cream can be effective in the prevention of keloid recurrences after surgical excision. To establish the safety and efficacy of imiquimod 5% cream in the prevention of recurrences of excised earlobe keloids. Patients who attended a dermatologic surgery clinic for the treatment of earlobe keloids were recruited into the study. Earlobe keloids underwent parallel shave excision. Imiquimod 5% cream was applied daily for 8 weeks followed by an observation period of 16 weeks. In patients who presented with bilateral earlobe keloids, paired comparisons of imiquimod versus intralesional steroid injections were performed. Eight earlobes were treated with imiquimod 5% cream after parallel keloid removal. Twenty-four weeks after surgery, six (75%) remained recurrence free. Four patients underwent bilateral paired comparisons. At the end of the observation period, two patients (50%) remained recurrence free in the imiquimod-treated areas while experiencing recurrences in the intralesional steroid-treated areas. Local irritation secondary to imiquimod application required rest periods in three cases. In all cases, patients were able to resume therapy and completed the study without further complications. Although small and uncontrolled, the results of this open-label, pilot study suggest that imiquimod 5% cream may prove to be a reasonably effective adjuvant therapeutic alternative for the prevention of recurrences in excised earlobe keloids.

Postsurgical Use of Imiquimod 5% Cream in the Prevention of Earlobe Keloid Recurrences

Postsurgical Use of Imiquimod 5% Cream in the Prevention of Earlobe Keloid Recurrences