Combined Treatment of Post Surgery Keloids in the Pediatric Population, Cases Report

Background:

Keloid scars present in the pediatric population a difficult treatment challenge due to lack of safety evaluation of chemotherapy and radiotherapy. Surgical treatment combined laser or steroid injection supposed to be options. We hypothesize that timing of steroid injection and pressure therapy may improve outcomes in combination with lesion excision, chemotherapy, or post-surgery radiotherapy.

Methods:

Five patients with 8 keloids occured after surgery were treated using steroid injection and pressure therapy, in combination with lesion excision. Strict follow-up was enforced, with continueous pressure clothes and repeat injections as needed at any sign of abnormal scar formation postoperatively. Dermascopy or 3D camera system were used to evaluate.

Results:

Of 8 lesions, 5 (62.5%) were treated successfully with no sign of lesion recurrence at 6 months of follow-up. Three lesions of long time follow-up and presented 12 months postoperatively with recurrence. These lesion were subsequently retreated.

Conclusions:

Steroids injection, pressure therapy and laser therapy in combination with excision is a well-tolerated and effective treatment of keloids in the pediatric population. Safety is the most important issue for evaluation. Contineous pressure and adherence to a strict follow-up regimen is crucial to success. Digital methods are promised to be widely applied for accurate observation.