Keloid scars on black skin: myth or reality

• Published in: Annales de chirurgie plastique et esthétique 2013-04, Vol.58 (2), p.115-122
• Main Authors: Allah, K C, Yéo, S, Kossoko, H, Assi Djè Bi Djè, V, Richard Kadio, M
• Format: Article
• Language: fre
• Subjects: Adolescent; Adult; African Continental Ancestry Group - statistics & numerical data; Child; Child, Preschool; Cicatrix - pathology; Cicatrix - therapy; Cote d'Ivoire - epidemiology; Female; Glucocorticoids - administration & dosage; Humans; Incidence; Injections, Intralesional; Keloid - epidemiology; Keloid - etiology; Keloid - pathology; Keloid - therapy; Male; Middle Aged; Reconstructive Surgical Procedures - methods; Recurrence; Risk Factors; Treatment Outcome
• ISSN: 1768-319X
• DOI: 10.1016/j.anplas.2012.02.005

The keloid scar is a thick skin or the cornea of man, due to excessive accumulation of type I collagen in the dermis. Morbidity of the keloid is high, given the frequent recurrences and unpredictable. African blacks and Asians are most affected. The purpose of this study was to analyze the results of treatment of 149 cases of keloids and discuss the reality of keloids in the dark. From 1990 to 2011, 98 patients were supported for 149 keloid tumors. Seventy-eight adults (79.6%) and 20 children (20.4%) were received. Sixty-four women (65.3%) and 34 men (34.7%) were supported, including 94 blacks (96%) and four redheads (4%). The average age was 25 years with extremes of 2 years and 54 years. The trauma was the dominant etiology in 63.1% of cases. The infection, burns and surgery were implicated in 16.8%, respectively, 15% and 4.7% of cases. The cephalic end, was the seat of choice for keloids, with 84 cases or 56.4%. The ear has been the preferred unit in 38 cases, or 25.5%. The body, legs and genital area were the site of keloids, respectively, in 22.8%, 17.5%) and 3.3% of cases. Keloidal field was found in 24.5% of our cases. The reasons for consultation were the disgrace aesthetics (56.4%), pain (65%), households suppurative intrakeloidal (44.9%), functional impairment (40.8%), and the psychological impact minor (15.3%) and no major suicide attempt (66.3%). Two surgical techniques were used: total excision (TE), with total skin graft immediate or deferred, or not expanded, and intrakeloid excision (IKE) with suture surgery was associated with intra-lesional steroids. Many complications have favored the occurrence of early or late recurrence in 100% of our cases. The keloid is not a homogenous biological entity. Its prevalence is higher among black and yellow, and lowest among whites. The research results are still being evaluated. The best prevention is to avoid the scar itself.