Introduction: Keloids are abnormal growths of fibrous tissue often seen on dark skin. We studied their clinical, epidemiological and therapeutic aspects in 456 consecutive cases.
Patients and methods: This retrospective study covering a 20-year period describes and analyzes all patients seen for keloids during that period.
Results: The age range of 15-24 year-olds was affected most often (35.72%), and the male/female sex ratio was 0.66. Pruritus was the most frequent symptom (72.23%). The zones at high risk for keloids were: the trunk (chest and abdominal area) (39.57%) and the face (10.65%).The most frequent causes were various sorts of trauma (75%), in descending order of frequency: cutaneous infections, surgical trauma, ulcerating lesions, and burns. The existence of spontaneous keloids remains controversial. Steroid infiltration used alone or with other medication remains the first-line treatment in our study.
Discussion: Our study confirms the high frequency of keloids in dark skin, especially females. The trunk and face are zones at high risk for keloid formation.
Conclusion: An underlying trauma must always be sought for keloids on dark skin.