Progression of Keloids Over Time
Keloid disorder is an active biological process. Over time, keloid lesions grow and become larger, and often merge with nearby keloids. This aspect of keloid biology has not been adequately studied. From observation alone, we can conclude that certain growth activating pathways remain active over time, and result in the 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 the 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 they remain autonomously active, causing growth and progression of the keloid. The images below show the progression of chest keloids in a particular patient. The images were taken approximately one year apart.
Serial images taken over time show the growth of a small keloid papule and its merger with the large adjacent keloid. The main keloid has been undergoing treatment. The discoloration of the larger keloid is due to the loss of pigment from repeated cryotherapy treatments.