Aggressive keloid scarring of the Caucasian wrist and palm

doi:10.1054/bjps.2001.3589

British Journal of Plastic Surgery

Volume 54, Issue 5, July 2001, Pages 461-462

https://doi.org/10.1054/bjps.2001.3589 Get rights and content

Summary

Keloid scarring of the distal upper extremity is very rare. We report a Caucasian woman who presented with aggressive keloids of the hand and wrist causing De Quervain's syndrome, superficial radial-nerve entrapment and ulnar-nerve compression at the wrist. Multiple operations were required to alleviate her symptoms. A number of management conundrums arose, requiring defensive planning to pre-empt the possible complications of recurrent keloid scarring as a result of the surgical procedures.

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Cited by (6)

Keloid formation after trigger finger release: A case report
2013, Journal of Plastic, Reconstructive and Aesthetic Surgery
Citation Excerpt :
This case was treated with keloid excision and full-thickness skin graft, without recurrence by 1 year postoperatively. Britto et al. reported the case of a white male in whom keloids of the wrist and the palm caused severe functional problems of the hand and the wrist over a 10-year period.2 Our report is the first to present keloid formation on the palm after trigger finger release.
We report a case of keloid formation on the palm of the hand after trigger finger release.
A 58-year-old male with trigger finger of the right index, middle and ring fingers was treated with open release at a nearby hospital. Three months after this operation, a progressively enlarging skin lesion formed at the surgical site. A diagnosis was made of keloid formation after trigger finger release, and keloid excision with full thickness skin graft and postoperative radiation therapy was done. One year postoperatively, the patient was asymptomatic and had not experienced a recurrence.
This is a first report about keloid formation on the palm after trigger finger release. Our patient had a good outcome with keloid excision, full thickness skin graft and postoperative radiation therapy.
Palmar and plantar keloid in a black African male
2012, Chirurgie de la Main
La cicatrice chéloïde est une tumeur cutanée fibreuse, intradermique, exubérante. Elle est fréquente sur la peau glabre. Les chéloïdes de la paume des mains et de la plante des pieds sont plutôt rares. De petites séries sont décrites dans la littérature anglo-saxonne. Les auteurs rapportent un cas de grosses chéloïdes de localisation à la fois palmaire et plantaire, dans un contexte de maladie chéloïdienne, chez un homme de 37 ans. À la main gauche, la chéloïde réalisait une syndactylie cicatricielle partielle IV-V. Aux pieds, de grosses tumeurs chéloïdiennes occupaient le bord médial et la zone non portante du pied droit, ainsi que la zone non portante du pied gauche. Ces tumeurs empêchaient le port de chaussures et gênaient la marche. Le traitement a consisté en une exérèse totale des tumeurs chéloïdiennes palmaires et plantaires. Les pertes de substance résiduelles étaient comblées par une greffe de peau totale prélevée au niveau de la région sus-pubienne. Les résultats étaient satisfaisants au plan esthétique, fonctionnel et psychosocial.
The keloid scar is a fibrous skin tumor, intradermal, and exuberant. It is commonly found on the glabrous skin. The keloid of the palms and soles are rare. Small series are reported in English literature. The authors report a case of large keloids located on both palms and soles, within a context of keloid disease, in a man of 37 years. On the left hand, the keloid scar caused a partial syndactyly IV-V. Large keloid tumors occupied the inner edge and, weight-bearing areas of both feet. These tumors rendered wearing of shoes impossible and interfered with walking. The treatment consisted of total excision of palmar and plantar keloid tumors. The residual defects were covered by a total skin graft taken from the suprapubic region. The results were satisfactory aesthetically, functionally and psychosocially.
Twenty-Year-Old Pathogenic "Active" Postsurgical Scar: A Case Study of a Patient With Persistent Right Lower Quadrant Pain
2007, Journal of Manipulative and Physiological Therapeutics
This case study describes a patient with persistent right lower quadrant and low back pain who experienced relief after manual mobilization techniques of an old appendectomy scar.
A 53-year-old man with pain in the right lower quadrant of the abdomen and low back had previously failed several trials of multimodal treatments. He had an irritated old appendectomy scar in the right lower quadrant. Degenerative disk findings were also noted in the upper lumbar spine.
Manual mobilization of the superficial and deep layers of the scar tissue was applied. The patient experienced an immediate pain reduction after the first treatment. Nine treatments in total were administered to the patient.
Assessment and treatment of “active” scar tissue may comprise an important component of the management of locomotor dysfunction and associated pain syndromes.
Abnormal wound healing: keloids
2007, Clinics in Dermatology
Citation Excerpt :
Some authors believe that keloids occur primarily in areas of high skin tension,1 but exceptions to this rule suggest this may be an oversimplification. Keloids appear rarely on the palms6 or soles,7,8 areas where we would expect significant skin tension. In addition, one of the most commonly affected sites, the earlobe,9 is under minimal tension.
Wound healing is a complex and carefully regulated physiologic response to a traumatic injury. Deregulation of this coordinated process can lead to exuberant scar formation as seen in keloids and hypertrophic scars. Despite their common occurrence, keloids remain one of the most challenging dermatologic conditions to successfully treat and may have significant psychosocial impact for the patient. In this review, we discuss the clinical features, genetics, epidemiology, and treatment of keloids.
Keloids: A rare location and review of the literature
2010, European Journal of Plastic Surgery
Keloid formation resulting in aquired syndactyly of an initially normal web space following syndactyly release of an adjacent web space
2008, Journal of Hand Surgery: European Volume

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Case reportAggressive keloid scarring of the Caucasian wrist and palm

Summary

J Hand Surg

Br J Plast Surg

Hand Clin

Case report
Aggressive keloid scarring of the Caucasian wrist and palm