Keloid Excision with Debulking Technique on the Lobule Auricle Sinistra

Abstract

Introduction: Keloids are fibroproliferative lesions caused by abnormal wound healing and are characterized by excessive collagen deposits that cannot heal spontaneously. Keloid in the ear is a challenging condition to be treated by doctors, especially the large ones. This condition has a psychosocial impact on the patient and a consideration for appearance is often the main reason for patients seeking to cure keloids, although there is a high possibility of keloid recurrence. Out of various keloid therapy options, one method that can be done is surgical excision therapy with debulking technique. Case report: A case of keloids in left ear lobule measuring 2.5 cm × 3 cm is reported after the patient does ear piercing with complaints of slight itch and aesthetical disturbance. Keloids enlarge 6 months after piercing. The case is treated by debulking excision surgery using local anesthesia Pehacain® (lidocaine 2% + adrenaline 1:80,000). At the end of the wound closure, 40 mg of triamcinolone acetone is given. It is regiven one week after the stitches are removed and repeatedly every 2 weeks for 4 times. Excision surgical results are good and the patient feels satisfied. Conclusion: Excision surgery with debulking technique is chosen because of the large size of the lesion and to ensure there is no residual keloid tissue at the site of predilection. Corticosteroid injection is given immediately after excision to decrease fibroblast proliferation, collagen and glycosaminoglycan synthesis and suppress proinflammatory mediators in order to prevent keloid recurrence.