Keloids: a prospective study of 57 cases.

Of the total 57 cases of keloids, 8 cases of massive keloids were treated by diathermy excision and immediate skin grafting; 35 keloids of ear lobule by intramarginal excision and post-operative local hydrocostisone; 7 presternal keloids by local corticoids alone and a miscellaneous group of 7 cases of keloids were treated by combination therapy. It is concluded that massive keloids with or without sinuses and keloidal contractures require surgery to improve appearance and function respectively. Ear lobule keloids are best treated by intramarginal excision and post-operative local hydrocortisone. Presternal keloids and small keloids elsewhere should be treated by intralesional injection of corticoids alone. Initial results of intramarginal excision with or without local corticoids were satisfactory. However it is too early to claim best result with this regimen, in the absence of long term follow up.