Ebook Manual of dermatologic therapeutics (8th edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Manual of dermatologic therapeutics (8th edition): Part 2
Ebook Manual of dermatologic therapeutics (8th edition): Part 2
Keloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re Ebook Manual of dermatologic therapeutics (8th edition): Part 2esponse to cutaneous injuries, such as acne, trauma, surgery, and piercing. Both are seen in all races, especially in individuals with dark skin. Common anatomic sites for both HSs and keloids include the earlobes, chest, lower legs, and upper back. In general, HSs remain in the area and shape of or Ebook Manual of dermatologic therapeutics (8th edition): Part 2iginal injury, whereas keloids expand beyond the site of initial trauma and can be recalcitrant to treatment.The pathogenesis of HSs and keloids is unEbook Manual of dermatologic therapeutics (8th edition): Part 2
clear. Fibroblasts from HSs and keloids demonstrate excessive proliferative and low apoptosis properties. In addition to rhe increasing production of Keloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re Ebook Manual of dermatologic therapeutics (8th edition): Part 2) appears to play a central role in the pathogenesis as evidence indicates that TGF-p isoforms 1 and 2 are particularly involved in collagen synthesis promotion and scarring, while isoform 3 is involved in scar prevention.II.CLINICAL PRESENTATION Keloids are usually asymptomatic, although some are p Ebook Manual of dermatologic therapeutics (8th edition): Part 2ruritic and others may be quire painful and tender (Figs. 25-1 and 25-2). Occasionally, there may be a functional impairment if the scar interferes wiEbook Manual of dermatologic therapeutics (8th edition): Part 2
th movement of the involved area. Keloids start as pink218 I MANUAL OF DERMATOLOGIC THERAPEUTICSFigure 25-2. This lesion is growing well beyond rhe boKeloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re Ebook Manual of dermatologic therapeutics (8th edition): Part 2d may become smoother, irregularly shaped, hyperpigmented, firm, and symptomatic.HSs appear as scars that are more elevated, wider, or thicker than expected and are confined within rhe size and shape of the inciting injury (Figs. 25-3 and 25-4).III.WORKUP The diagnosis of keloids and HSs is usually Ebook Manual of dermatologic therapeutics (8th edition): Part 2made with clinical observation; a biopsy will confirm the diagnosis. The patient may give a history of previous trauma, while keloid formation can devEbook Manual of dermatologic therapeutics (8th edition): Part 2
elop spontaneously with dermatologic diseases like Rubinstein-Taybi and Goeminne syndromes. Other causes, if present, should be investigated and treatKeloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re Ebook Manual of dermatologic therapeutics (8th edition): Part 2reactions, and local infections with herpes virus or vaccinia virus (Table 25-1).IV.TREATMENT HSs usually require no treatment and often resolve spontaneously in 6 to 12 months. Intralesional corticosteroid injection is an effective treatment, and excision is another viable option because most HSs d Ebook Manual of dermatologic therapeutics (8th edition): Part 2o nor recur. Pulsed dye laser (PĐL) (585 ro 595 nm) surgery is also another effective modality; rhe laser treatment decreases redness and scar mass anEbook Manual of dermatologic therapeutics (8th edition): Part 2
d improves subjective symptoms. Some clinicians feel that rhe combination of intralesional steroid and PĐL is more effective than either used alone. KKeloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re Ebook Manual of dermatologic therapeutics (8th edition): Part 2ce (Tibies 25-2 and 25-3).219Chapter 25 • Keloids and Hypertrophic Scars IFigure 25-3. Hypertrophic scars characteristic of acne scars that occur on rhe trunk. (From Goodheart HP. Goodheart's Photoguide of Common Skin Disorders. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003.)Figure 2 Ebook Manual of dermatologic therapeutics (8th edition): Part 25-4. Hypertrophic scars in healed deep partial-thickness burns mnci/tpr-ililp tvirípnr rlicmmi/MT -Jtirt miwrv íínp rn flip irz'liitio wirmrh220 I MANEbook Manual of dermatologic therapeutics (8th edition): Part 2
UAL OF DERMATOLOGIC THERAPEUTICSTABLE 25-1Differential Diagnosis•Dermatofibroma•Dermatofibrosarcoma protuberans•Foreign-body reaction•Lobomycosis•SarcKeloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re Ebook Manual of dermatologic therapeutics (8th edition): Part 2nation with cryosurgery, please refer to table 25-3)Common Treatment Options at a GlanceTABLE 25-3TreatmentCommentsIntralesional steroidsMay be used in combination with cryosurgery, pulsed dye laser, 5-fluorouracil, and surgerySilicone gel sheetingMay be used in combination after surgery or other th Ebook Manual of dermatologic therapeutics (8th edition): Part 2erapeutic modalitiesCryoMay be used in combination with intralesional corticosteroidsKeloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing reKeloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing reGọi ngay
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