Superficially Spreading Keloids:
As keloid grow over time, they can expand and involve large areas of the skin. The rate of growth of keloids, and the extent of skin involvement is keloid patients is dictated by several factors. The most important factor that determines the extent of skin involvement is the "genetics" of the illness. Patients with the more severe form of this disorder will have several keloids that grow fast and become larger in a short period of time. This is in contrast with those who only develop one or few small lesions.
The next most important factor that determines the rate of growth and shape of a keloid, is the "surgical intervention". Almost all patients with very bad cases of keloids are those who have had a prior keloid removal surgery. As wider and larger portions of skin are removed, keloidal wound healing will results in formation of very large keloids.
Treatment of superficially spreading keloids is quite challenging. These keloids grow and spread over a wide area of the skin; and if they occur over the joints, they can often result in limitations of the range of motion of the joints.