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Ebook Manual of dermatologic therapeutics (8th edition): Part 2

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Nội 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. Comm

on 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 2

iginal injury, whereas keloids expand beyond the site of initial trauma and can be recalcitrant to treatment.The pathogenesis of HSs and keloids is un

Ebook 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 2

ruritic 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 wi

Ebook 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 bo

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 2d may become smoother, irregularly shaped, hyperpigmented, firm, and symptomatic.HSs appear as scars that are more elevated, wider, or thicker than ex

pected 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 2

made with clinical observation; a biopsy will confirm the diagnosis. The patient may give a history of previous trauma, while keloid formation can dev

Ebook 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 treat

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 2reactions, and local infections with herpes virus or vaccinia virus (Table 25-1).IV.TREATMENT HSs usually require no treatment and often resolve spont

aneously 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 2

o nor recur. Pulsed dye laser (PĐL) (585 ro 595 nm) surgery is also another effective modality; rhe laser treatment decreases redness and scar mass an

Ebook 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. K

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 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 r

he 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 2

5-4. Hypertrophic scars in healed deep partial-thickness burns mnci/tpr-ililp tvirípnr rlicmmi/MT -Jtirt miwrv íínp rn flip irz'liitio wirmrh220 I MAN

Ebook Manual of dermatologic therapeutics (8th edition): Part 2

UAL OF DERMATOLOGIC THERAPEUTICSTABLE 25-1Differential Diagnosis•Dermatofibroma•Dermatofibrosarcoma protuberans•Foreign-body reaction•Lobomycosis•Sarc

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 2nation with cryosurgery, please refer to table 25-3)Common Treatment Options at a GlanceTABLE 25-3TreatmentCommentsIntralesional steroidsMay be used i

n 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 2

erapeutic modalitiesCryoMay be used in combination with intralesional corticosteroids

Keloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re

Keloids andHypertrophic ScarsYoon-Soo Cindy Bae-HarboeI.BACKGROUND Keloids and hypertrophic scars (HSs) represent an excessive and aberrant healing re

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