“Butterfly Keloids” refer to the keloids that their appearance is mimics that of a butterfly. These keloids grow from their sides and lateral edges. As they grow sideways, the edges may separate and form several lines of growth. This pattern of keloid growth is commonly seen in keloids that form in central chest area, over the sternum bone.
Keloids that form in the center of the chest are the most difficult keloids to treat with very high failure rate with any form of treatment. Surgery carried a 100% risk of recurrence, and often time significant worsening of these keloids. Addition of radiation to surgery for treatment of these keloids, although performed by some, is not advised by Dr. Tirgan. Radiation therapy carried significant risk of causing long term side effects, such as cancer; a risk that is not justified in treatment of a benign condition.
Best method of treatment for these keloids is conservative medical management. Steroid injections have minimal efficacy in this situation. Cryotherapy alone, although somewhat effective, will not result in total clearance of these keloids. The best results are achieved by combining intra-lesional chemotherapy with intra-lesional steroids and cryotherapy in a planned sequence that will take various factors into consideration. Some of these factors are: patient's age, size of the lesions, prior treatments, presence or absence of other keloids lesions and stage of keloid disorder.