Keloids: a review of the literature.

A review of the literature on keloids, a complex and poorly understood subject, is presented. Keloid is a disease principally of the human dermis, and occasionally the cornea, appearing as thick scar tissue invading normal skin or cornea and produced by the deposition of excessive amounts of collagen over prolonged periods. The African negro is particularly susceptible. Available methods of treatment include surgical excision, external superficial radiotherapy, interstitial irradiation, intralesional steroid injections, cryotherapy, ultrasound, systemic chemotherapy, zinc tape strapping, pressure and silicone gel. Any of these could be used alone or in combination with other forms of treatment. The lesions are notoriously recurrent and their management frustrating. The risk of late tumour induction following radiotherapy and systemic complications of depot steroids are underlined. There is still the need for a better understanding of the behaviour of keloids. This should form the biological basis on which to plan more effective prevention and treatment, with minimal complications.