Progression of Keloids Over Time
Keloid disorder is an active biological process. Over time, keloid lesions grow and become larger, and often merge with the nearby keloids. This aspect of keloid biology has not been adequately studied. Clearly, from observation alone, we can conclude that certain growth activating pathways remain active over time and result in progression and enlargement of keloids. Formation of keloid lesions is triggered by an injury to skin which results in the induction of pathological pathways that ultimately lead to development of keloid tissue. These "keloidal" pathways are either shut down at some point in future, resulting in a growth arrest of the keloid, or the pathways remain autonomously active and are not shut down, thereby causing growth and progression of the keloid lesions. Images below clearly show the progression of the chest keloids in this particular patient. The images were taken are approximately one year apart.
The blue arrow above points to the area where two adjacent keloids have now merged. Much research is needed to better understand the biology of this understudied disorder.