Keloids of Abdominal Wall:
As opposed to chest and shoulder area, abdominal skin is a not a common area for keloid formation. Perhaps less than 2% of all keloid patients, black or white, have some form of involvement of the abdominal skin which is often subsequent to a prior surgery or piecing. Rarity of true primary abdominal wall keloids is a testament to the patchy nature of keloid skin involvement with almost 90% of patients having their keloids above the diaphragm level. As opposed to keloids of other parts of the skin, abdominal keloids are not race-specific and seen almost equally among all races. Umbilical keloids, on the other hand, are gender-specific and seen almost exclusively in women.
Umbilical area is a common site for both piercing as well as laparoscopic surgical interventions. The clinical presentation of the umbilical keloids is distinctly different among Asian/Caucasians as opposed to black skin individuals, with bulky and tumoral types of umbilical keloids only seen among blacks.
Umbilical Keloid in a middle age African American female. Note properly healed incisional wound above the keloid.
Treatment of abdominal keloids, much like other keloids, requires patience and perseverance. Surgery and radiation therapy have to be avoided at all cost. The best method to treat bulky abdominal keloids is with Cryotherapy.