The Effectiveness of Meticulous Surgery and Postoperative Steroid Injection for Treatment of Auricular Keloids
Keywords:
Auricular keloid, excision and keloid fillet flap, intralesional steroid injectionAbstract
Background: The treatment of auricular keloids is known to be difficult because of high recurrence rate aftersurgery. Many adjuvant therapies had been used including intralesional steroid injection.
Objective: To evaluate the effectiveness of meticulous surgery and postoperative steroid injection for the
treatment of auricular keloids.
Methods: From October 2011 to September 2014, 38 patients with ear keloids (total 62 ear keloids) were treated
with intralesional excision and closure of the defect using keloid fillet flap. Postoperative intralesional steroid injection
was administered for the first time at 2- week and then every 4 weeks for 2 times (total 3 times). Recurrence rate, aesthetic
results, symptomatic improvement and the adverse effects were evaluated.
Results: The follow-up period ranged from 6-32 months (mean 18.09 months). Four from 38 patients recurred
(recurrent rate 10.52%). All patients were satisfied with the aesthetic results and had symptomatic improvement without
any complications.
Conclusion: Meticulous surgery (excision and keloid fillet flap) and 3-time postoperative intralesional steroid
injection can be effective for treatment of the auricular keloids.
References
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for the management of ear keloids: results of excision
combined with intraoperative and postoperative steroid
injections. Plast Reconstr Surg 2007;120:1395-400.
9. Jin YJ, Mi RR, Yeon SK, Kee YC. Surgery and perioperative
intralesional corticosteroid injection for treating earlobe keloids
: A Korean experience. Ann Dermatol 2009; 21: 221-5.
10. Reuben FS, Bijitesh C, Alok S, M Alam P, Anil M. Efficacy of triple
therapy in auricular keloids. Cutan Aesth Surg 2014;7:98-102.
11. Sclafani AP, Gordon L, Chadha M, Romo T. Prevention of
earlobe keloid recurrence with postoperative corticosteroid
injections versus radiation therapy: a randomized, prospective
study and review of the literature. Dermatol Surg 1996;22:569-
74.
12. Ragoowansi R, Cornes PGS, Glees JP, Powell BW, Moss ALH.
Earlobe keloids: treatment by a protocol of surgical excision
and immediate postoperative adjuvant radiotherapy. Br J
Plast Surg 2001;54:504-8.
13. Stahl S, Barnea Y, Weiss J, et al. Treatment of earlobe keloids
by extralesional excision combined with preoperative and
postoperative çsandwiché radiotherapy. Plast Reconstr Surg
2010;125:135-41.
14. Ogawa R, Huang C, Akaishi S, et al. Analysis of surgical
treatments for earlobe keloids: analysis of 174 lesions in 145
patients. Plast Reconstr Surg 2013;132:818-25.
15. Russell R, Horlock N, Gault D. Zimmer splintage: a simple
effective treatment for keloids following ear-piercing. Br J
Plast Surg 2001;54:509-10.
16. Park TH, Seo SW, Kim JK, Chang CH. Outcomes of surgical
excision with pressure therapy using magnets and identification
of risk factors for recurrent keloids. Plast Reconstr Surg
2011;128:431-9.
17. Gregor MB, Jorn B, Karl H, Boris AS. Auricular keloids: combined
therapy with a new pressure device. Arch Facial Plast Surg
2012;14:20-6.
18. Yigit B, Yazar M, Alyanak A, Guven E. A custom-made silicon
mold for pressure therapy to ear keloids. Aesth Plast Surg
2009;33:849-51.
19. Careta MF, Fortes AC, Messina MC, Maruta CW. Combined
treatment of earlobe keloids with shaving, cryosurgery and
intralesional steroid injection: a 1-year follow-up. Dermatol
Surg 2013;39:734-8.
20. Chi SG, Kim JY, Lee WJ, et al. Ear keloids as a primary candidate
for the application of mitomycin C after shave excision: in vivo
and in vitro study. Dermatol Surg 2011; 37: 168-75.
editors. Aesthetic dermatology. New York: McGraw-Hill,
1991:58-64.
2. Lee Y, Minn KW, Baek RM, Hong JJ. A new surgical treatment
of keloid: keloid core excision. Ann Plast Surg 2001;46:135-40.
3. Brown NA, Ortega FR. The role of full-thickness skin grafting
and steroid injection in the treatment of auricular keloids. Ann
Plast Surg 2010;64:637-8.
4. Kim DY, Kim ES, Eo SR, Kim KS, Lee SY, Cho BH. A surgicalapproach for earlobe keloid: keloid fillet flap. Plast Reconstr
Surg 2004;113:1668-74.
5. Al Aradi IK, Alawadhi SA, Alkhawaja FA, Alaradi I. Earlobe
keloids: a pilot study of the efficacy of keloidectomy with core
fillet flap and adjuvant intralesional corticosteroids. Dermatol
Surg 2013;39:1514-9.
6. Mafong EA, Ashinoff R. Treatment of hypertrophic scars and
keloids: A review. Aesth Surg 2000;3:114-21.
7. Shons AR, Press BH. The treatment of earlobe keloids by
surgical excision and postoperative triamcinolone injection.
Ann Plast Surg 1983;10:480-2.
8. Rosen DJ, Patel MK, Freeman K, Weiss PR. A primary protocol
for the management of ear keloids: results of excision
combined with intraoperative and postoperative steroid
injections. Plast Reconstr Surg 2007;120:1395-400.
9. Jin YJ, Mi RR, Yeon SK, Kee YC. Surgery and perioperative
intralesional corticosteroid injection for treating earlobe keloids
: A Korean experience. Ann Dermatol 2009; 21: 221-5.
10. Reuben FS, Bijitesh C, Alok S, M Alam P, Anil M. Efficacy of triple
therapy in auricular keloids. Cutan Aesth Surg 2014;7:98-102.
11. Sclafani AP, Gordon L, Chadha M, Romo T. Prevention of
earlobe keloid recurrence with postoperative corticosteroid
injections versus radiation therapy: a randomized, prospective
study and review of the literature. Dermatol Surg 1996;22:569-
74.
12. Ragoowansi R, Cornes PGS, Glees JP, Powell BW, Moss ALH.
Earlobe keloids: treatment by a protocol of surgical excision
and immediate postoperative adjuvant radiotherapy. Br J
Plast Surg 2001;54:504-8.
13. Stahl S, Barnea Y, Weiss J, et al. Treatment of earlobe keloids
by extralesional excision combined with preoperative and
postoperative çsandwiché radiotherapy. Plast Reconstr Surg
2010;125:135-41.
14. Ogawa R, Huang C, Akaishi S, et al. Analysis of surgical
treatments for earlobe keloids: analysis of 174 lesions in 145
patients. Plast Reconstr Surg 2013;132:818-25.
15. Russell R, Horlock N, Gault D. Zimmer splintage: a simple
effective treatment for keloids following ear-piercing. Br J
Plast Surg 2001;54:509-10.
16. Park TH, Seo SW, Kim JK, Chang CH. Outcomes of surgical
excision with pressure therapy using magnets and identification
of risk factors for recurrent keloids. Plast Reconstr Surg
2011;128:431-9.
17. Gregor MB, Jorn B, Karl H, Boris AS. Auricular keloids: combined
therapy with a new pressure device. Arch Facial Plast Surg
2012;14:20-6.
18. Yigit B, Yazar M, Alyanak A, Guven E. A custom-made silicon
mold for pressure therapy to ear keloids. Aesth Plast Surg
2009;33:849-51.
19. Careta MF, Fortes AC, Messina MC, Maruta CW. Combined
treatment of earlobe keloids with shaving, cryosurgery and
intralesional steroid injection: a 1-year follow-up. Dermatol
Surg 2013;39:734-8.
20. Chi SG, Kim JY, Lee WJ, et al. Ear keloids as a primary candidate
for the application of mitomycin C after shave excision: in vivo
and in vitro study. Dermatol Surg 2011; 37: 168-75.
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Published
2015-06-30
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Watcharhachittitam A. The Effectiveness of Meticulous Surgery and Postoperative Steroid Injection for Treatment of Auricular Keloids. Thai J Surg [Internet]. 2015 Jun. 30 [cited 2024 Nov. 22];36(2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226192
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