Clinical Features:

• Keloids are defined as scars that grow beyond the area of the wound that provoked them.
• Hypertrophic scars are defined as raised, exuberant scars that remain localized to the wound area.
• The clinical and histologic distinction between the two is not always crisp.
• Keloids can sometimes become quite disfiguring when of large size.  Their etiology is unknown.  They are significantly more common in blacks.

Histologic Features:

• Keloids:
  • Broad, haphazardly arranged, brightly eosinophilic collagen bundles
  • Increased fibroblasts interspersed among the collagen bundles
  • Usually elevated above the skin surface, often with an atrophic overlying epidermis
• Hypertrophic scars:
  • Dense collagen bundles oriented parallel to the epidermal surface
  • Marked increase in fibroblasts in the area of the hypertrophic collagen 
  • The scar shows minimal to no elevation above the skin surface.

Cases associated with this book:

Keloid
Author: Stephen Lyle, M.D., Ph.D.

Conference: DermatopathologyConsultations.com Teaching Collection