Papers of The 2nd Japan Scar Workshop

8. Exclusive Diagnosis of Diseases that Resemble Keloids and Hypertrophic Scars

Rei Ogawa, Satoshi Akaishi, Kyoko Kobe, Shimpei Ono, Hiko Hyakusoku
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan

From April 2003 to March 2007, we examined 378 patients self-diagnosed with keloids or hypertrophic scars. We detected four other diseases (1.06%) in the group of patients. All tumors were benign: apocrine cystadenoma, adult-onset juvenile xanthogranuloma, mixed tumor, and chronic folliculitis. Although we detected no malignancies, malignant tumors can resemble keloids or hypertrophic scars, including dermatofibrosarcoma protuberans (DFSP) and fibroblastoma, and differential, or exclusive, diagnosis of diseases similar to keloids and hypertrophic scars is important. We found the following considerations important in the examination of keloids or hypertrophic scars: biopsies should be conducted in anomalous cases since malignant disease might be an initial or secondary problem, steroid injection should be performed only after careful consideration since malignancy or infections might be present, and the presence of bacterial or fungal infection should be investigated.
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