Rapid Recurrence of Keloid after Pulse Dye Laser Treatment

摘要

Keloids and hypertrophic scarring are frequently encountered in the clinical setting and can be quite difficult to treat. Keloids, in particular, are prone to overgrowth, and as disease activity can remain active for or be reactivated after years of dormancy, great deformity can arise. Differing hypotheses regarding the formation of keloids have led to a myriad of treatments as the pathogenesis behind keloidal growth has not yet been fully elucidated. Pulse dye laser fPDL) has been suggested as an effective therapeutic modality for hypertrophic scars and keloids. We report a case of rapid recurrence of keloid within 1 week of PDL treatment for telangiectasia.A 21-year-old healthy woman with Fitzpatrick Skin Phototype IV presented for treatment of large keloids over the V-region of her chest. Her medical history was unremarkable except for facial acne vulgaris treated with a short course of oral doxy-cycline and topical agents including adapalene. Her keloids were treated with intralesional (IL) injections of triamcinolone acetonide (diluted to 20mg/mL weekly for six visits, lOmg/mL biweekly for eight visits, 5 mg/mL biweekly for five visits, and 5 mg/mL monthly for five visits). The protrusion of the keloids gradually decreased, and marked improvement of pruritus was noted.