Surgical Management of a Case of Bilateral Auricular Keloids in an Adolescent Girl

Abstract

The Keloid is a fibroproliferative anomaly of the cutaneous connective tissue secondary to dysregulation in the skin healing and repair process, occurring in susceptible individuals. It is characterized by excessive collagen and glycoprotein deposition in the dermis following any local irritation, inflammation, burn, incision or injury, thereby leading to a cosmetically unaesthetic, aberrant and exuberant scar formation extending well beyond the boundaries of the original wound. It usually presents as firm nodules, often pruritic and painful, which do not regress spontaneously. The condition presents quite a therapeutic challenge owing to its unpredictably aggressive nature, frequent invasion of adjacent normal dermis, occasional appearance of satellite lesions in nearby non-traumatized tissue and a remarkable tendency for recurrence following removal. Various combinations of Pressure therapy, intralesional steroid therapy and surgery have shown promising results in the treatment of auricular keloids. We report on a young Indian female, aged 19 years, who developed bilateral auricular keloids subsequent to earlobe piercing, which was successfully managed by careful and atraumatic surgical excision alone.