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Advancing Keloid Treatment: A Novel Multimodal Approach to Ear Keloids
Michael E Jones1, Jennifer McLane, Rachael Adenegan
1*Lexington Plastic Surgeons, New York, New York; †Hunter-Bellevue School of Nursing, Hunter College, New York, New York.
Background/Objective:
Management of keloids of the pinna, in particular, those located in the helix and antihelix and lobule that occur as complications of ear piercing.
Materials And Methods:
Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT). Radiation protocol consisted of 1 to 3 fractions, with cumulative dosage ranging from 1,300 to 1,800 cGy. Average follow-up was 24 months to assess for evidence of recurrence and adverse side effects.
Results:
Fifty ear keloids were treated with this method, age from 15 to 66 (mean = 32, SD = 16) of which 14 were male and 35 female. Almost 30% (n = 14) of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who reported recurrence.
Conclusion:
Surgical excision combined with intraoperative PRP, adjuvant postoperative in-office SRT achieved a 94% nonrecurrence rate on follow-up over a 2-year period. Outcomes provide preliminary, albeit, strong evidence to support this multimodal method as a viable alternative in the management of keloids localized to the ear.