Combination Therapy for a Severe Axillary Keloid with Abscesses: A Case Report

Area of Science:

• Dermatology
• Plastic Surgery
• Oncology

Background:

• Keloids are fibroproliferative disorders causing significant motor function limitation and painful infections.
• Severe keloids can spread widely, posing a challenge for effective treatment.
• Giant keloids, like the one described, require innovative therapeutic approaches.

Observation:

• A patient presented with a giant keloid originating from a childhood vaccination site, which had grown extensively over decades.
• The keloid caused significant cosmetic disfigurement, pain, and restricted movement.
• Initial suspicion of malignancy was ruled out by biopsy, confirming a diagnosis of a giant keloid.

Findings:

• A combination therapy involving partial surgical resection with local flap transposition, followed by radiotherapy and steroid-plaster treatment, was implemented.
• Postoperative radiotherapy and 18 months of steroid-tape therapy were administered to the residual keloid.
• At 18 months post-treatment, no recurrence was observed, with complete resolution of pain and movement restriction.

Implications:

• This case suggests that a multimodal approach combining surgery, radiotherapy, and steroid therapy can be effective for managing severe and extensive keloids.
• The treatment improved the patient's quality of life significantly.
• Further research is needed to establish a standard treatment protocol for severe keloid cases.