Keloid
https://en.wikipedia.org/wiki/Keloid
relevance score : -100.0%
References
Keloid 29939676 NIH
Mae keloidau yn ffurfio oherwydd iachâd anarferol ar ôl anaf i'r croen neu lid. Mae ffactorau genetig ac amgylcheddol yn cyfrannu at eu datblygiad, gyda chyfraddau uwch mewn unigolion â chroen dywyllach o dras Affricanaidd, Asiaidd a Sbaenaidd. Mae keloidau yn digwydd pan fydd ffibroblastau'n gorfywiog, gan gynhyrchu colagen gormodol a ffactorau twf. Mae hyn yn arwain at ffurfio bwndeli colagen mawr, annormal a elwir yn colagen keloidal (keloidal collagen), ynghyd â chynnydd mewn ffibroblastau. Yn glinigol, mae keloidau yn ymddangos fel nodwlau rwber cadarn mewn ardaloedd a anafwyd yn flaenorol. Yn wahanol i greithiau arferol, mae keloidau yn ymestyn y tu hwnt i'r safle trawma gwreiddiol. Gall cleifion brofi poen, cosi neu losgi. Mae triniaethau amrywiol ar gael, gan gynnwys pigiadau steroid, cryotherapi, llawdriniaeth, radiotherapi, a therapi laser.
Keloids result from abnormal wound healing in response to skin trauma or inflammation. Keloid development rests on genetic and environmental factors. Higher incidences are seen in darker skinned individuals of African, Asian, and Hispanic descent. Overactive fibroblasts producing high amounts of collagen and growth factors are implicated in the pathogenesis of keloids. As a result, classic histologic findings demonstrate large, abnormal, hyalinized bundles of collagen referred to as keloidal collagen and numerous fibroblasts. Keloids present clinically as firm, rubbery nodules in an area of prior injury to the skin. In contrast to normal or hypertrophic scars, keloidal tissue extends beyond the initial site of trauma. Patients may complain of pain, itching, or burning. Multiple treatment modalities exist although none are uniformly successful. The most common treatments include intralesional or topical steroids, cryotherapy, surgical excision, radiotherapy, and laser therapy.
Keloid treatments: an evidence-based systematic review of recent advances 36918908 NIH
Mae'r ymchwil presennol yn awgrymu mai silicone gel neu silicone sheeting ynghyd â corticosteroid injections yw'r driniaeth gychwynnol a ffefrir ar gyfer keloidau. Gellir hefyd ystyried triniaethau ychwanegol fel 5-fluorouracil intralesional (5-FU), bleomycin, neu verapamil, er bod eu heffeithiolrwydd yn amrywio. Gall laser therapy, o'i gyfuno â corticosteroid injections neu topical steroids dan gyfyngiad, wella treiddiad cyffuriau. Ar gyfer keloidau ysbeidiol, dangoswyd bod tynnu llawfeddygol ac yna radiation therapy ar unwaith yn effeithiol. Yn olaf, profwyd bod defnyddio silicone sheeting a pressure therapy yn lleihau'r tebygolrwydd y bydd keloid yn digwydd eto.
Current literature supports silicone gel or sheeting with corticosteroid injections as first-line therapy for keloids. Adjuvant intralesional 5-fluorouracil (5-FU), bleomycin, or verapamil can be considered, although mixed results have been reported with each. Laser therapy can be used in combination with intralesional corticosteroids or topical steroids with occlusion to improve drug penetration. Excision of keloids with immediate post-excision radiation therapy is an effective option for recalcitrant lesions. Finally, silicone sheeting and pressure therapy have evidence for reducing keloid recurrence.
Keloids: a review of therapeutic management 32905614 NIH
Ar hyn o bryd, nid oes un driniaeth sy'n addas i bawb sy'n gwarantu cyfradd ailadrodd gyson isel ar gyfer keloids. Fodd bynnag, mae'r opsiynau cynyddol, fel defnyddio lasers ochr yn ochr â steroids neu gyfuno 5‑fluorouracil â steroids, yn profi'n addawol. Gallai ymchwil yn y dyfodol ganolbwyntio ar ba mor dda y mae triniaethau newydd, fel autologous fat grafting neu stem cell‑based therapies, yn gweithio ar gyfer rheoli keloids.
There continues to be no gold standard of treatment that provides a consistently low recurrence rate; however the increasing number of available treatments and synergistic combinations of these treatments (i.e., laser-based devices in combination with intralesional steroids, or 5-fluorouracil in combination with steroid therapy) is showing favorable results. Future studies could target the efficacy of novel treatment modalities (i.e., autologous fat grafting or stem cell-based therapies) for keloid management.
Scar Revision 31194458 NIH
Mae creithiau yn rhan gyffredin o'r broses wella ar ôl anafiadau i'r croen. Yn ddelfrydol, dylai creithiau fod yn wastad, yn denau, ac yn cyfateb i liw'r croen. Gall llawer o ffactorau arwain at wella clwyfau gwael, megis haint, llai o lif gwaed, isgemiad (ischemia), a thrawma. Gall creithiau sy'n drwchus, yn dywyllach na'r croen o'u cwmpas, neu'n crebachu'n ormodol achosi problemau sylweddol gyda gweithrediad corfforol ac iechyd emosiynol.
Scars are a natural and normal part of healing following an injury to the integumentary system. Ideally, scars should be flat, narrow, and color-matched. Several factors can contribute to poor wound healing. These include but are not limited to infection, poor blood flow, ischemia, and trauma. Proliferative, hyperpigmented, or contracted scars can cause serious problems with both function and emotional well-being.
Gwelir keloid scars yn amlach mewn pobl o dras African, Asian neu Hispanic. Mae gan bobl rhwng 10 a 30 oed more likely to develop keloids than older adults.
Er eu bod fel arfer yn digwydd ar safle anaf, gall keloid arise spontaneously hefyd. Gallant ddigwydd ar safle piercing a hyd yn oed o rywbeth mor syml â pimple neu scratch. Gallant ddigwydd o ganlyniad i severe acne neu chickenpox scarring, infection at a wound site, repeated trauma to an area, excessive skin tension during wound closure, neu foreign body in a wound.
Gall keloid scars ddatblygu ar ôl surgery. Maent yn fwy cyffredin mewn rhai safleoedd, megis y central chest (sternotomy), y cefn a'r ysgwyddau (sy'n deillio o acne fel arfer), a ear lobes (from ear piercings). Gallant hefyd ddigwydd ar other body piercings. Y mannau mwyaf cyffredin yw ear lobes, arms, pelvic region, a over the collarbone.
Y triniaethau sydd ar gael yw pressure therapy, silicone gel sheeting, intra‑lesional triamcinolone acetonide, cryosurgery, radiation, laser therapy, Interferon, 5‑FU a surgical excision.
○ triniaeth
Gall hypertrophic scars wella gyda 5 i 10 intralesional steroid injections at one‑month intervals. #Triamcinolone intralesional injection
Gellir rhoi cynnig ar laser treatment ar gyfer erythema sy'n gysylltiedig â scarring, ond gall triamcinolone injections hefyd wella'r erythema trwy flattening the scar. #Dye laser (e.g. V-beam)