Division of Pediatric Surgery, Department of Surgery, University of Florida College of Medicine, 1600 SW Archer Rd. P.O. Box 10019, Gainesville, FL, USA.
J Pediatr Surg. 2020 Mar;55(3):461-464. doi: 10.1016/j.jpedsurg.2019.07.006. Epub 2019 Jul 24.
Keloids occur as a result of abnormal wound healing and as many as 70% of keloids and hypertrophic scars affect the pediatric population. Earlobe keloids, similar to lesions elsewhere in the body, remain a challenging problem given the high rates of recurrence and lack of consensus regarding treatment strategy. This study aims to evaluate the outcomes and patterns of recurrences following treatment of earlobe keloids in a large cohort of pediatric patients to facilitate identification of the optimal treatment strategy.
All pediatric patients who underwent surgical therapy for earlobe keloids over a 10-year period (2004-2015) were identified and demographic, clinical and outcomes data were collected. A follow-up phone survey was administered to assess rates of long-term recurrence and overall satisfaction with the treatment strategy. Data analysis was performed using Student's t-test and Fisher's exact as appropriate.
A total of 94 patients with 135 keloids were identified. Mean age was 14 years with slight preponderance of females (52%) and a majority (75%) of the patients were African American (AA). Mean keloid size was 2.4 cm (0.25-11 cm) with ear piercing being the most common inciting etiology. Excision with steroid injection (59%) was the most frequent treatment approach followed by excision alone (25%). During a median follow up of 2 years, keloid recurrence occurred in 27 (28.7%) patients, 19 (70.4%) underwent additional therapy with 10 (52.6%) re-recurrences noted. Median time to recurrence was 23 months, with a slightly higher recurrence rate in AA patients (32%; p = 0.26) and in those age < 10 years (50%; p = 0.11).
This represents the largest series of earlobe keloids treatment in children. Our data suggest that recurrence rates are unaffected by the age at excision and race of the patient. Moreover, adjuncts to excisional therapy such as steroid injection, compression therapy and radiation also did not appear to influence recurrence. Given the pattern of recurrences studies with longer term follow-up are needed to assess the efficacy of treatment strategies.
Case series.
IV.
瘢痕疙瘩是由于伤口愈合异常而产生的，多达 70%的瘢痕疙瘩和增生性瘢痕会影响儿童人群。与身体其他部位的病变类似，耳垂瘢痕疙瘩由于复发率高，且对于治疗策略缺乏共识，仍然是一个具有挑战性的问题。本研究旨在评估大量儿科患者耳垂瘢痕疙瘩治疗后的结果和复发模式，以确定最佳治疗策略。
确定了在 10 年期间（2004-2015 年）接受耳垂瘢痕疙瘩手术治疗的所有儿科患者，并收集了人口统计学、临床和结果数据。通过电话随访评估长期复发率以及对治疗策略的总体满意度。使用学生 t 检验和 Fisher 精确检验进行数据分析。
共确定了 94 名患有 135 个瘢痕疙瘩的患者。平均年龄为 14 岁，女性略占优势（52%），大多数（75%）患者为非裔美国人（AA）。平均瘢痕疙瘩大小为 2.4cm（0.25-11cm），最常见的发病原因是耳部穿孔。切除加类固醇注射（59%）是最常见的治疗方法，其次是单纯切除（25%）。在中位随访 2 年期间，27 名（28.7%）患者出现瘢痕疙瘩复发，其中 19 名（70.4%）接受了额外治疗，10 名（52.6%）出现了再复发。复发的中位时间为 23 个月，AA 患者（32%；p=0.26）和年龄<10 岁的患者（50%；p=0.11）的复发率略高。
这是儿童耳垂瘢痕疙瘩治疗的最大系列。我们的数据表明，复发率不受患者年龄和种族的影响。此外，切除术后辅助类固醇注射、压迫治疗和放射治疗等治疗方法似乎也不会影响复发。鉴于复发模式，需要进行长期随访研究以评估治疗策略的疗效。
病例系列研究。
IV 级。
