WordNet

mark with a scar; "The skin disease scarred his face permanently" (同)mark, pock, pit
a mark left (usually on the skin) by the healing of injured tissue (同)cicatrix, cicatrice
raised pinkish scar tissue at the site of an injury; results from excessive tissue repair (同)cheloid

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(皮膚の)『傷跡』;(物の表面の)傷跡 / 心の傷跡,痛手;(名誉などを傷つける)汚点 / (植物の茎などに残る)葉印,葉痕(ようこん) / …‘に'傷跡を残す / 〈傷などが〉傷跡を残す《+『over』》
カリエス(骨・歯などの組織の崩れ)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/22 20:46:10」(JST)

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A keloid (/ˈkiːlɔɪd/; also keloidal scar)^[1] is the formation of a type of scar^{[citation needed]} which, depending on its maturity, is composed mainly of either type III (early) or type I (late) collagen. It is a result of an overgrowth of granulation tissue (collagen type 3) at the site of a healed skin injury which is then slowly replaced by collagen type 1. Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to the colour of the patient's flesh or red to dark brown in color. A keloid scar is benign and not contagious, but sometimes accompanied by severe itchiness, pain,^[2] and changes in texture. In severe cases, it can affect movement of skin. Keloid scars are seen 15 times more frequently in highly pigmented ethnic groups than in Caucasians.

Keloids should not be confused with hypertrophic scars, which are raised scars that do not grow beyond the boundaries of the original wound.

Signs and symptoms

Keloids expand in claw-like growths over normal skin.^[3] They have the capability to hurt with a needle-like pain or to itch without warning, although the degree of sensation varies from person to person.

If the keloid becomes infected, it may ulcerate. Removing the scar is one treatment option; however, it may result in more severe consequences: the probability that the resulting surgery scar will also become a keloid is high, usually greater than 50%. Laser treatment has also been used with varying degrees of success.

Keloids form within scar tissue. Collagen, used in wound repair, tends to overgrow in this area, sometimes producing a lump many times larger than that of the original scar. Although they usually occur at the site of an injury, keloids can also arise spontaneously. They can occur at the site of a piercing and even from something as simple as a pimple or scratch. They can occur as a result of severe acne or chickenpox scarring, infection at a wound site, repeated trauma to an area, excessive skin tension during wound closure or a foreign body in a wound. Keloids can sometimes be sensitive to chlorine. Keloid scars can grow, if they appear at a younger age, because the body is still growing.

Location

Keloids can develop in any place where skin trauma has occurred. They can be the result of pimples, insect bites, scratching, burns, or other skin injury. Keloid scars can develop after surgery. They are more common in some sites, such as the central chest (from a sternotomy), the back and shoulders (usually resulting from acne), and the ear lobes (from ear piercings). They can also occur on body piercings. The most common spots are earlobes, arms, pelvic region, and over the collar bone.

Cause

Most skin injury types can contribute to scarring. This includes acne scars, burns, chickenpox scars, ear piercing, scratches, surgical cuts or vaccination sites.

According to the National Center for Biotechnology Information, keloid scarring is common in young people between the ages of 10 and 20, and among African American, Asian, and Hispanic persons.

Keloids tend to have a genetic component, which means one is more likely to have keloids if one or both of their parents has them.^[4]

Pathology

Micrograph of keloid. Thick, hyalinised collagen fibres are characteristic of this aberrant healing process. H&E stain.

Histologically, keloids are fibrotic tumors characterized by a collection of atypical fibroblasts with excessive deposition of extracellular matrix components, especially collagen, fibronectin, elastin, and proteoglycans. Generally, they contain relatively acellular centers and thick, abundant collagen bundles that form nodules in the deep dermal portion of the lesion. Keloids present a therapeutic challenge that must be addressed, as these lesions can cause significant pain, pruritus (itching), and physical disfigurement. They may not improve in appearance over time and can limit mobility if located over a joint.

Keloids affect both sexes equally, although the incidence in young female patients has been reported to be higher than in young males, probably reflecting the greater frequency of earlobe piercing among women. The frequency of occurrence is 15 times higher in highly pigmented people. African descendant people have increased risk of keloid occurrences.^[5]

Treatments

The best treatment is prevention in patients with a known predisposition. This includes preventing unnecessary trauma or surgery (including ear piercing, elective mole removal), whenever possible. Any skin problems in predisposed individuals (e.g., acne, infections) should be treated as early as possible to minimize areas of inflammation.

Should keloids occur, the most effective treatment is superficial external beam radiotherapy (SRT), which can achieve cure rates of up to 90%.

Additionally, intralesional injection with a corticosteroid such as Kenalog does appear to aid in the reduction of inflammation and pruritis.^[6]

Cryotherapy or Cryosurgery is an application of extreme cold to treat keloids. This treatment method is easy-to-perform and has shown results with least chance of recurrence.^[7]

Epidemiology

Persons of any age can develop a keloid. Children under 10 are less likely to develop keloids, even from ear piercing. Keloids may also develop from Pseudofolliculitis barbae; continued shaving when one has razor bumps will cause irritation to the bumps, infection, and over time keloids will form. Persons with razor bumps are advised to stop shaving in order for the skin to repair itself before undertaking any form of hair removal. The tendency to form keloids is speculated to be hereditary.^{[citation needed]} Keloids can tend to appear to grow over time without even piercing the skin, almost acting out a slow tumorous growth; the reason for this is unknown.

History

Gordon, with keloids from being whipped.^[8]

Keloids were described by Egyptian surgeons around 1700 BC. Baron Jean-Louis Alibert (1768–1837) identified the keloid as an entity in 1806. He called them cancroïde, later changing the name to chéloïde to avoid confusion with cancer. The word is derived from the Greek χηλή, chele, meaning "hoof", here in the sense of "crab pincers", and the suffix -oid, meaning "like". For many years, Alibert's clinic at Hôpital Saint-Louis was the world’s center for dermatology.

References

^ Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. p. 1499. ISBN 1-4160-2999-0.
^ Ogawa, Rei (2010). "The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids". Plastic and Reconstructive Surgery 125 (2): 557–68. doi:10.1097/PRS.0b013e3181c82dd5. PMID 20124841.
^ Babu, M; Meenakshi, J; Jayaraman, V; Ramakrishnan, KM (2005). "Keloids and hypertrophic scars: A review". Indian Journal of Plastic Surgery 38 (2): 175–9. doi:10.4103/0970-0358.19796.
^ http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001852/^{[full citation needed]}
^ Wound Healing, Keloids at eMedicine
^ http://journals.lww.com/plasreconsurg/Citation/1966/09000/The_Treatment_of_Keloids_with_Triamcinolone.4.aspx
^ http://www.keloidresearchfoundation.org/treatment-options.php
^ Collins, Kathleen (1985). "The scourged back". History of Photography 9 (1): 43–5. doi:10.1080/03087298.1985.10442251.

External links

Keloids and hypertrophic scars, german version (Rossmann N, 2004)

UpToDate Contents

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1. ケロイドおよび肥厚性瘢痕 keloids and hypertrophic scars
2. にきびの傷のマネージメント management of acne scars
3. Laser therapy for hypertrophic scars and keloids
4. 熱傷後のケロイドおよび肥厚性瘢痕のマネージメント management of keloid and hypertrophic scars following burn injuries
5. 熱傷再建の原則：四肢および所属リンパ節領域 principles of burn reconstruction extremities and regional nodal basins

English Journal

Interventions for acne scars.

Abdel Hay R1, Shalaby K, Zaher H, Hafez V, Chi CC, Dimitri S, Nabhan AF, Layton AM.
The Cochrane database of systematic reviews.Cochrane Database Syst Rev.2016 Apr 3;4:CD011946. [Epub ahead of print]
BACKGROUND: Acne scarring is a frequent complication of acne and resulting scars may negatively impact on an affected person's psychosocial and physical well-being. Although a wide range of interventions have been proposed, there is a lack of high-quality evidence on treatments for acne scars to bet
PMID 27038134

Novel X-linked syndrome of cardiac valvulopathy, keloid scarring, and reduced joint mobility due to filamin A substitution G1576R.

Atwal PS1,2,3, Blease S1, Braxton A2, Graves J4, He W2, Person R2, Slattery L1, Bernstein JA1, Hudgins L1.
American journal of medical genetics. Part A.Am J Med Genet A.2016 Apr;170(4):891-5. doi: 10.1002/ajmg.a.37491. Epub 2015 Dec 21.
Filamin A (FLNA) is known to be involved in intracellular actin binding, cell migration, scaffolding, and signaling. We report a novel X-linked syndrome characterized by cardiac valvular disease, keloid scarring and reduced joint mobility in male second cousins due to a previously unreported mutatio
PMID 26686323

[Keloid scars (part I): Clinical presentation, epidemiology, histology and pathogenesis].

Philandrianos C1, Kerfant N2, Jaloux C Jr3, Martinet L4, Bertrand B3, Casanova D3.
Annales de chirurgie plastique et esthétique.Ann Chir Plast Esthet.2016 Apr;61(2):128-35. doi: 10.1016/j.anplas.2015.09.005. Epub 2015 Nov 3.
Keloid scars are a dysregulated response to cutaneous wound healing and are characterized by excessive deposition of collagen. Clinical and histological aspects are typical but they are often confused with hypertrophic scars. Principal pathogenesis is abnormal regulation of the collagen equilibrium
PMID 26545809

Japanese Journal

肥厚性瘢痕・ケロイド治療の現況 (特集わが国の形成外科とその進歩)

日本医師会雑誌 = The Journal of the Japan Medical Association 145(3), 479-483, 2016-06
NAID 40020840099

レックリングハウゼン病で傷が綺麗に治る理由 (シンポジウム神経線維腫の外科的治療)

日本レックリングハウゼン病学会雑誌 7(1), 14-16, 2016-04
NAID 40020859237

Objective Spectrometric Measurement of Keloid Color in the East Asian Population: Pitfalls of Subjective Color Measurements

Journal of Nippon Medical School 83(4), 142-149, 2016
NAID 130005266343

Related Pictures

★リンクテーブル★

リンク元	「瘢痕ケロイド」「ケロイド瘢痕」「ケロイド性瘢痕」
関連記事	「caries」

「瘢痕ケロイド」

Keloid
	Postoperative keloid on the wrist
Classification and external resources
Specialty	Dermatology
ICD-10	L91.0
ICD-9-CM	701.4
MedlinePlus	000849
eMedicine	article/1057599 article/1298013
Patient UK	Keloid
MeSH	D007627