Definition: skin lesions caused by high fibroblast proliferation and collagen production as excessive tissue response to, typically small, skin injuries
Etiology: imbalance in wound healing processes due to local factors and genetics
Pathophysiology
Increased synthesis and unorganized deposition of collagen type I and collagen type III
Increased TGF-β expression and fibroblast proliferation
Clinical features
Brownish-red scar tissue of varying consistency (soft or hard) with claw-like appearance that grows beyond the boundaries of the original lesion
Pruritus
Pain
Localization: earlobes, face (especially cheeks), upper extremities, chest, and neck
Diagnosis: based on clinical appearance of lesion and patient history of trauma or surgery
Treatment: same as for hypertrophic scars (see above)
Keloid scars recur after surgical excision in up to 100% of cases. A combined approach to treatment may have more success than surgery alone.
