Hypertrophic scars and kelloids

    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.
    External Links:

    Cases associated with this book:

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

    Conference: DermatopathologyConsultations.com Teaching Collection