Location of Keloids and Its Treatment Modality May Influence the Keloid Recurrence in Children

Until now, clinical studies dealing with pediatric keloids are extremely rare considering widespread controversies over the mode of inheritance of keloids. To the best of the authors' knowledge, there have been no reports analyzing this condition systemically. The purpose of this study was to summarize the baseline characteristics of a cohort of pediatric patients and recommend our effective regimens. A total of 203 pediatric patients with keloid were treated at our hospital.

The authors retrospectively analyzed data including patient age, sex, etiology, anatomic location, previous treatment history and modalities, and etiology. Of the 203 patients, 167 (82.3%) were women and 36 (17.7%) were men. The average age was 15 years (interquartile range 12-18 years). The locations of our keloids in order of frequency were the ear, upper and lower extremities, shoulder and deltoid area, chest, abdomen and perineum, and face and neck. The number of patients treated for a primary keloid was 174 (85.7%), and remaining 29 patients (14.3%) were treated for a recalcitrant/recurrent keloid that failed to respond to other prior treatments. These prior treatments included single therapies such as steroid injection, excision, laser therapy, and a combination of excision with intralesional steroid injection.

Of these patients, 88.6% had successful treatment of their keloids, whereas 11.4% had recurrences. Events of keloid recurrence were associated with anatomic areas and treatment modalities. Keloids occurring at lower extremity and chest areas have high propensity to recur even after completion of successful treatment. In addition, combination treatments such as surgical excision followed by full-thickness skin grafting and steroid injections, and surgical excision followed by steroid injections are also associated with high recurrence rate.

The authors successfully treated pediatric keloids selecting proper regimen according to anatomic locations. Based on our study of 230 pediatric keloids, 2 characteristics were linked to the risk of keloid recurrence.