Comprehensive Review of Keloid Formation

Abstract

Keloid is a benign fibrous growth, which presents in scar tissue of predisposed individuals. Although the pathogenesis of keloid disease is not well understood, it is considered to be the end product of an abnormal healing process. There are several molecules and cells implicated in keloid mechanism in relation to the normal wound healing process. However, it is possible that several factors such as age of onset, sex, cause of scarring, blood groups, anatomical site, presence of family history, number of injured sites (multiple/ single), and modifiable factors like delayed healing, and hypertension have an important role in keloid formation and consequentially in predicting keloid's behavior in response to treatment and prognosis. Keloids appear as firm, mildly tender, bosselated tumors with a shiny surface. The main differential diagnosis of keloid is hypertrophic scar, also called pseudokeloid, which not only a clinical challenges, but also histological challenge. No single therapeutic modality is best for all keloids. The location, size, and depth of the lesion; the age of the patient; and the past response to treatment determine the type of therapy used, so there are several options in keloid treatment. Prevention is the first rule in keloid therapy, so we must take special care in treating patients with a history of keloids. This review gives a comprehensive view of keloid formation (pathogenesis, risk factors, diagnosis, different diagnosis, histopathology, treatment and prevention) and this is the object of this review.