[Keloids. A fibroproliferative disorder of unknown etiology]

We review recent advances in keloid research and treatment. Keloids are benign tumours of the skin. They tend to occur in younger patients after different kinds of injuries, infections or they may develop spontaneously. In contrast to hypertrophic scars, keloids are not confined to the original wound, but grow into the corresponding healthy skin. They rarely recede within time. Most patients complain of itching and suffer from impairment of their quality of life. Only little is known about the pathogenesis of keloids, although they have been clinically well characterized for a long time. New results point towards a disruption in the signaling pathway of TGFbeta. In addition there seems to be evidence of an increased familiar incidence and therefore the genetic background should be screened. Successful treatment of keloids is difficult. As contact cryotherapy and intralesional corticosteroid injections are in most cases not successful, the pulsed dye-laser seems to be a promising alternative. In addition topical treatment with extracts of onions, occlusive silicone sheets and pressure improves the clinical appearance of keloids.