Keloids: Which treatment is best for your patient?
Corticosteroid injections have proven effective for many patients, but other options may be more appropriate depending on the keloid’s location.
Other methods may produce suboptimal results. Cryotherapy causes ischemic damage that reduces tumor bulk at least temporarily, but is inappropriate for darker skin due to a high risk of persistent hypopigmentation.1,26,27 Intralesional antifibrotic cytokines, such as interferon, reduce collagen synthesis in vitro,1 but lead to considerable systemic adverse effects including headache, myalgias, and influenza-like symptoms.3,5 Skin grafting is inappropriate as it may lead to keloid wave formation at the graft edges.
CORRESPONDENCE
Stephen P. Daane, MD, 2186 Geary Boulevard #212, San Francisco, CA 94115; stevedaane@gmail.com
