Keloids: a review.

Keloids are predominantly fibrous tumors which appear as firm, variably pruritic or tender growths near a site of injury. Usually appearing between the ages of 10 and 30, most keloids are located on the upper back, shoulders, earlobes, and anterior portion of the chest. The etiology remains unknown, but the accumulated fibrous tissue is associated with increased cellularity and increased metabolic activity of keloid fibroblasts. Isolated keloid fibroblasts demonstrate normal growth characteristics along with increased collagen and proteoglycan synthesis. Numerous keloid treatments have been attempted, but variable success has followed either single use or combinations of intralesional corticosteroid injection, surgery, pressure devices, radiation, cryosurgery, and systemic chemotherapy.