CHALLENGING KELOID CASES - UNDERGOING TREATMENT
This is the newest section of our website. We will post some of our current and challenging cases who are undergoing active treatment.
his is a 36-year-old female with very painful and tender chest wall keloid as depicted below.
This keloid first developed when she was a child, subsequent to chicken pox infection. Surgical removal of this keloid was attempted, but it resulted in worsening of the keloid. She has received multiple steroid injections and uses silicone sheets with minimal relief.
The keloid has been very painful and tender to touch. Steroid injections have been extremely painful and have resulted in no clinical benefit. She was self-referred to Dr. Tirgan in June 2014 for management of this keloid.
Dr. Tirgan's Treatment approach to this keloid
This is a very challenging case. The patient is suffering from tremendous pain in her chest that radiates to a great distance from the keloid tissue itself.
This patient suffers from a "hyper-inflammatory" chest wall keloid. The main goal of treatment at this time is to control the pain and once that is achieved, we will need to address the keloid itself. After lengthy discussions with the patient, we chose to proceed with intra-lesional chemotherapy as the first step in treating her keloid. She received her first treatment on July 15, 2014.
The rationale to use chemotherapy as the first treatment step was based on the fact that she has failed to respond to intra-lesional steroids. Intra-lesional chemotherapy is a better treatment option at the current time.
Treatment will result in some degree of excess pain for a few days, starting 24-48 hours after the injection and lasting 5-7 days. A potent pain medicine was prescribed for the management of treatment-induced pain in case that becomes necessary. We hope to see a reduction in the overall keloid pain in two weeks.
Cryotherapy was considered but applying cryotherapy to a very painful keloid like hers is very challenging on its own. Cryotherapy will be reserved for when her keloid pain comes under control with medical treatment.
She was advised to return in two weeks at which point we will post an update.
the video below, this patient speaks about her experience with the keloid, as well as with chemotherapy injections.