Butterfly-Shape Keloids:
Butterfly Keloids refer to the keloids that their appearance mimics that of a butterfly. These keloids almost always grow from their outer 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 the central chest area and over the sternum.
Butterfly-Shape Keloid in a young asian female
ButterflyShape keloid in an elderly African American Female. This painful keloid has been present for several decades, causing the patient constant discomfort. This keloid proved to be extremely resistant to all kinds of treatment, including cryotherapy and intralesional chemotherapies.
Treatment of Butterfly-Shape Keloids
Keloids that form in the center of the chest are by far the most difficult keloids to treat. Surgery carries a 100% risk of recurrence, and often results in significant worsening of these keloids. The addition of radiation to surgery for treatment of chest keloids, although performed by some, is not advised by Dr. Tirgan. Radiation therapy carries a risk of causing long-term side effects such as cancer; a risk that is not justified in the 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 or 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 the stage of keloid disorder.