Pathology of Keloid
When we look at keloids under a microscope, we see two components: the normal skin, and the disease. Skin has two layers, the Epidermis, which is the thin top layer, and the Dermis, the deeper layer of the skin. The pathology of a keloid resides in the dermis, where we see excessive amounts of tightly packed collagen fibers which are randomly oriented in multiple directions.
Keloid Tissue under microscope - Low magnification.
The dark layer on top is the Epidermis. The pink layer is the dermis that is infiltrated with collagen and the keloidal cells that produce it, known as fibroblasts.
Keloid Tissue under microscope - high magnification.
Much of the pink color tissue is made of disorganized keloidal collagen fibers. The blue spots are the nuclei of the cells that reside in the keloid tissue, mostly the fibroblasts, as well as lymphcytes (blood cells).