Before and after devastating recurrent keloids of the ear in a 27 year old woman. She had previously undergone surgery and multiple steroid injections, with recurrence of her keloids worse than before. The original wounds to the earlobes were routine ear piercings that became infected.
She had a genetic predisposition for true keloid formation. A keloid is a benign scar tumor – the body continues to produce thick, red, itchy and painful collagen for months to years, growing far beyond the boundaries of the original wound. Keloids are different from hypertrophic scars, which are immature, red, raised and sometimes itchy and painful scars but which remain within the boundaries of the wound.
A combined approach to treatment was used. Surgery excised the keloids and local tissue rearrangement under magnification preserved the delicate blood supply to the ear cartilage and reconstructed a normal ear shape. If the blood supply to ear cartilage becomes damaged or if blood collects beneath ear skin, permanent warping and deformation of the ear can occur. This is known in wrestlers, MMA fighters and rugby players as “cauliflower ear”.
Within 24 hours of surgical reconstruction, three daily 5 minute radiation treatments were delivered by the Radiation Oncology team at the hospital. This combined approach of surgery and radiation has the highest success rate for difficult refractory keloids like this young woman’s case.
Follow up images are shown at 9 months after surgery. She now feels comfortable wearing her hair tied back and has lost the stigma associated with such a deforming scar tumor. She required two steroid injections for mild hypertrophic scar formation after surgery but she had not had recurrence of the keloids.
*All photos are actual patient photographs and are for illustrative purposes only. Individual results may vary.
