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Tratamento de queloide retroauricular: revis?o dos casos tratados no servi?o de otorrinolaringologia do HC/UFPR
Carvalho, Bettina;Ballin, Annelyse Cristine;Becker, Renata Vecentin;Ribeiro, Talita Beithum;Cavichiolo, Juliana Benthien;Ballin, Carlos Roberto;Mocellin, Marcos;
International Archives of Otorhinolaryngology , 2012, DOI: 10.7162/S1809-97772012000200007
Abstract: introduction: keloids are benign tumors arising from abnormal healing of the skin, and there are several procedures available for their treatment. objective: the objective of this study was to evaluate the outcomes of patients undergoing treatment of keloids after ear, nose, and throat (ent) surgeries at our service center. method: we conducted thorough, retrospective and prospective analysis of records of patients undergoing treatment of retroauricular keloids at our center. results: nine patients were evaluated, and 6 underwent resection and adjuvant beta-therapy, 2 underwent resection with local application of corticosteroids, and only 1 underwent resection without adjuvant therapy. there was no recurrence of keloids in patients that were treated with beta-therapy in the early postoperative period. one patient had relapsed despite corticosteroid administration and late beta-therapy. discussion: several techniques have been used for the treatment of retroauricular keloids, and beta-therapy is thought to yield the best results, followed by the use of intralesional corticosteroids. conclusion: treatment of retroauricular keloids remains a challenge. while new techniques are being developed, resection followed by early beta-therapy is still the best treatment option.
A organiza??o da Enfermagem do HC-UFPR: refletindo sobre seus determinantes
Bernardino, Elisabeth;Felli, Vanda Elisa Andres;
Revista Brasileira de Enfermagem , 2006, DOI: 10.1590/S0034-71672006000200005
Abstract: the present study aimed at identifying the historical determinants that influenced nursing from the hc-ufpr, and the managerial models used in its different historical moments. this is a retrospective research which data was collected by interviews with people who lived in those occasions. the data was categorized in historical periods and their respective models of organization. afterwards the data was analyzed by the materialistic paradigm. as final results, the study shows the several stages of the nursing organization at this hospital, according to the determinants from each historical moment and some considerations of nursing insertion in this new model.
Treatment of keloids and hypertrophic scars  [cached]
Mutalik Sharad
Indian Journal of Dermatology, Venereology and Leprology , 2005,
Abstract: Clinicians always find it difficult to treat hypertrophic scars and keloids. Various treatment modalities are available. Intralesional corticosteroids, topical applications, cryotherapy, surgery, laser therapy, and silicone sheeting are the widely used options. Radiation therapy can also help in cases of recalcitrant keloids. Most recently, pulsed-dye laser has been successfully used to treat keloids and hypertrophic scars. There are no set guidelines for the treatment of keloids. Treatment has to be individualized depending upon the distribution, size, thickness, and consistency of the lesions and association of inflammation. A combination approach to therapy seems to be the best option.
Dermal cylindroma with multiple keloids
Vora Nitin,Vora Vatsala,Mukhopadhyay Amiya,Shah Parag
Indian Journal of Dermatology, Venereology and Leprology , 1993,
Abstract: A 30-year old lady presented with dermal cylindroma on the right upper chest. She also had multiple keloids.
Aetiology of Keloids – An Overview
R. Devika,S. Nazareth Arockiamary
Research in Biotechnology , 2011,
Abstract: Keloids are firm, rubbery lesions or shiny, fibrous nodules, and can vary from pink to flesh-coloured or red to dark brown in colour, benign, non-contagious, and sometimes accompanied by severe itchiness and pain, which affects the movement of skin. Keloids scar formation is nearly 1000 years old aetiology and pathogenesis is still poorly understood. Current paper is an overview of the aetiology, formation and the severity of keloids. It also gives the complete information of the prevailing treatment and its complications, and few case studies to strengthen the current strategy.
Eruptive keloids after chickenpox  [cached]
Nicolas Kluger,Antoine Mahé,Bernard Guillot
Dermatology Reports , 2011, DOI: 10.4081/dr.2011.e15
Abstract: Hypertrophic scars and keloids result from abnormal wound healing in predisposed individuals. They occur within months of cutaneous trauma (surgical wounds, piercing, lacerations) or inflammation (acne, folliculitis, vaccination site). They have rarely been reported after chickenpox. Herein we report a dramatic case in a 4-year-old black girl and discuss the issues related to the management of hypertrophic scars and keloids in this peculiar situation.
Management of chest keloids
Tae Hwan Park, Sang Won Seo, June Kyu Kim, Choong Hyun Chang
Journal of Cardiothoracic Surgery , 2011, DOI: 10.1186/1749-8090-6-49
Abstract: Keloids are relatively resistant to treatment, with high recurrence rates using a single treatment modality. Keloids have a tendency to recur after surgical excision as a single treatment, with rates approximately up to 80-100%. Keloids can arise from skin trauma and must be removed through skin truma. Therein lies the challenge of treatment, where recurrence would seem inevitable. Surgical excision is considered as a kind of skin trauma and it promotes additional collagen synthesis, resulting in regrowth and even larger keloids[1]. This is why we were focused on the article recently published in your esteemed journal by Patel et al.[2] that dealt with the challenging topic of chest keloids.58 patients were treated with surgical excision combined with intraoperative/postoperative intralesional steroid injection therapy over a period of six years from July 2003 to June 2009 at our hospital. In all patients, a follow-up period of 18 months was required. Treatment outcome was assessed with global aesthetic improvement score (GAIS). All statistical analyses were conducted using SPSS version 17.0 (SPSS, Inc., Chicago, IL, USA). Our data were not normally distributed; consequently non-parametric tests were used. Descriptive statistics are presented as medians with interquartile ranges or as numbers and percentages.41 (70.7%) were women and 17 (29.3%) were men. The average age was 32 (range 29-35). The average time interval between keloid formation (or prior complete treatment) and time of treatment was 6 (range 5-7) years. The average pretreatment total size of lesions was 3.5 (range 2.0-5.0). 45 patients (29.3%) were treated for a treatment-resistant keloid that failed to respond to previous interventions. These included surgical excision (2 patients, 3.4%), intralesional steroid injection (33 patients, 56.9%), laser therapy (5 patients, 8.6%), acupuncture (3 patients, 5.3%), and cryotherapy (2 patients, 3.4%). The etiologies of chest keloid, in order of decreasing frequ
Keloids and Hypertrophic Scars
Basant Kaushik,Ravindra Gendle,Shekhar Verma,Laxmi Verma
Pharmaceutical Reviews , 2008,
Abstract: A keloid is a benign, well-demarcated area of fibrous tissue overgrowth that extends beyond the original defect. A hypertrophic scar is similar but remains confined to the initial defect and tends to resolve with time. An imbalance of matrix degradation and collagen biosynthesis resulting in excess accumulation of collagen in the wound has been postulated to be the primary biochemical features of this skin lesion. Keloid and hypertrophic scars derived fibroblasts produce increased amount of collagen per cell compared with normal fibroblasts. Treatment has to be individualized depending upon the distribution size, thickness and consistency of the of the lesion and association of inflammation. Prevention is the key, but therapeutic treatment of hypertrophic scars and keloids includes a large number of options and among these options the most commonly used corticosteroid is triamcinolone acetonide. Studies have shown that up to 50% of the cases showed significant improvement with respect to scar color itching and scar elevation.
A Case for “Radiolysis” in Radiotherapy of Keloids  [PDF]
K. Malaker, H. Weatherburn, H. De Souza
International Journal of Medical Physics,Clinical Engineering and Radiation Oncology (IJMPCERO) , 2014, DOI: 10.4236/ijmpcero.2014.34029
Abstract: Successful treatment of keloids has eluded the medical community since their first description. Multitudes of therapeutic options are available, but none achieves satisfactory resolution of keloids. One major stumbling block is lack of understanding about their genesis. Assuming keloids are tumors, attempts have been made to treat this condition with standard radiotherapy, with dismal results. Keloidal masses are not an active biological entity. They are aggregations of cellular, hypovascular, hypoxic bundles of collagen, which are produced by atypical fibroblasts in the wounds and eventually cease production due to a hostile biological environment. Having no demonstrable inherent process of disposal of these collagen bundles, this excessive collagen tends to linger to form the bulk of keloids. The lesions eventually become symptomatic and aesthetically unacceptable, and therapeutic intervention is sought. Of all available treatments, such as post-resection radiotherapy, primary radiotherapy in selected cases and primary brachytherapy stand out above any other form of treatment. Be it brachytherapy or external beam treatment, one fundamental aspect of radiation action is the process of “radiolysis”, explaining why “radiobiological” approaches have been ineffective.
Is There an Association between Keloids and Blood Groups?  [PDF]
Abas Mouhari-Toure,Bayaki Saka,Koussaké Kombaté,Sefako Akakpo,Palakiyem Egbohou,Kissem Tchanga?-Walla,Palokinam Pitche
ISRN Dermatology , 2012, DOI: 10.5402/2012/750908
Abstract: Objective. The aim of the study is to investigate the possible associations between the blood groups ABO and Rhesus systems and the presence of keloids in patients with black skin. Method. This case-control study was conducted between September 2007 and August 2011 comparing dermatologic outpatients with keloids to matched controls recruited in preanesthetic consultation at Tokoin Teaching Hospital of Lomé (Togo). Results. The distribution of different ABO blood groups and Rhesus blood groups in both groups (cases versus controls) was not significantly different. This distribution of different blood groups was superimposed on the general population of blood donors at the National Blood Transfusion Center of Lomé. Univariate analysis between each blood group and the presence of keloid does not yield any statistically significant association between blood groups and presence of keloids in the subjects. Conclusion. The study shows no significant association between blood groups and the presence of keloids in our patients. Further investigation needs to be conducted to elucidate this hypothesis further by conducting multicenter studies of several ethnic groups. 1. Introduction Keloids are defined as intradermal tumors corresponding to an abnormal response of tissue to injury in predisposed individuals [1]. Factors that play a major role in keloid development are genetic predisposition coupled with some forms of skin trauma. Transforming growth factor has been implicated as the main factor responsible for the abnormal proliferation of keloid fibroblasts and excessive production of collagen. The red cell alloantigens of blood group are present on the membrane surface of red blood cells and certain epithelial cells [2]. Several publications have documented the associations between blood group and certain skin diseases [3–9]. In a study conducted in 1969 to 1970 on 486 patients with keloids in the city of Madras, South Indian, Ramakrishnan et al. in 1974 had found a predominance of blood group A, compared to the local population of this city (34.96% against 21.38% in the local population) [10]. And up to today, no studies have confirmed this association. In the context of our study, in the sub-Saharan Africa, the prevalence of keloids is high, and keloids represent 1.2% of dermatological consultations in Lomé [11]. In addition, the difficulties of management are arguments to search for possible factors associated with these conditions, and for their possible prevention. The main objective of this study is to investigate possible associations between blood
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