Multiple keloids developed after a patient had an ear lobe piercing, got worse after excision
A 48-year-old black woman presented with a 24-year-history of keloids on her bilateral earlobes. The keloids were formed following ear piercing. One year after the keloid on the earlobes, she had undergone therapeutic excision. However, excision resulted in the extension of the scar to the neck regions bilaterally.
In the current presentation, the patient complained of gradually progressive, extensive, painless, firm, brown/ black-coloured, circumscribed masses over her neck’s anterolateral aspects. Moreover, the lesions were in continuity with keloidal masses of her earlobes bilaterally. The patient revealed that the disease had gradually worsened over the course of 3 years.
Besides the above findings, the rest of the physical examination was unremarkable. Neither there were other scars on the body nor any systemic involvement. Moreover, a family history of similar symptoms was negative. the patient denied any other medical condition including viral infection, autoimmune or other related pathological entity.
Therefore, the treating physician considered keloid, granuloma faciale, lobomycosis and keloid morphea (nodular keloidal scleroderma) as differential diagnoses.
Since the patient reported that the local excision previously resulted in keloid extension, the physician decided not to opt for it this time. Therefore, the physician administered 3 intralesional injections of triamcinolone acetate at 3-month intervals with daily pressure therapy for 2 years. The patient had a satisfactory outcome.
Cugno S, Rizis D, Cordoba C. Beyond the borders of keloid formation: A case report. Can J Plast Surg. 2011;19(1):e10-e11.