SPECIAL TOPIC Keloid Pathogenesis and Treatment

Background: Keloid management can be difficult and frustrating, and the mechanisms underlying keloid formation are only partially understood. Methods: Using original and current literature in this field, this comprehensive review presents the major concepts of keloid pathogenesis and the treatment options stemming from them. Results: Mechanisms for keloid formation include alterations in growth factors, collagen turnover, tension alignment, and genetic and immunologic contribu-tions. Treatment strategies for keloids include established (e.g., surgery, steroid, radiation) and experimental (e.g., interferon, 5-fluorouracil, retinoid) regi-mens. Conclusion: The scientific basis and empiric evidence supporting the use of various agents is presented. Combination therapy, using surgical excision fol-lowed by intradermal steroid or other adjuvant therapy, currently appears to be the most efficacious and safe current regimen for keloid management. (Plast. Reconstr. Surg. 117: 286, 2006.