A primary care perspective on keloids

Abstract

Keloids are a common presenting complaint in the primary care clinic. This condition presents a formidable challenge, as recurrence is often difficult to prevent despite use of multiple therapeutic interventions. Part of the reason for the absence of a definitive treatment is the incomplete understanding of the pathogenesis of keloid formation, which creates a frustrating situation for both physician and patient. Here we review the most recent literature on the clinical features, pathogenesis, and management of keloids, with special emphasis on the unique challenges faced by primary care physicians.

Figures

Figure 1

Two angles of a 40-year-old black woman with a hypertrophic scar following right-sided open cholecystectomy.

Figure 2

Close-up of keloid with typical raised area with flat surface. The base is wider than the top.

Figure 3

Young white female with hypertrophic scar at initial presentation (top panels) and after gradual regression (lower panels).

Figure 4

19-year-old Hispanic woman with an earlobe keloid before (top panels) and after (lower panels) treatment with steroid injection.