Short Communication: Successful treatment of recalcitrant keloid – a combined approach

Sir, keloids are the result of an overgrowth of dense fibrous tissue that usually develops after healing of a skin injury. The tissue extends beyond the borders of the original wound, does not usually regress spontaneously. Although the basis for keloid formation has not been fully delineated, an imbalance of matrix degradation and collagen biosynthesis resulting in excess accumulation of collagen in the wound have been postulated to be the primary biochemical features of keloidal lesions. Fibroblasts of keloidal lesion produce increased amount of collagen per cell compared with normal fibroblasts. There are no set guidelines for the treatment of keloids. Treatment has to be individualized depending upon the distribution, size, thickness, and consistency of the lesions and association of inflammation. Treatment modalities for keloids and hypertrophic scars include compression garments, radiation, excision, intralesional injections, cauterization, cryotherapy, laser surgery, and silicon gel dressings. We report a case of recalcitrant keloid treated successfully with a new combined approach.