CLINICAL AND CLINICOPATHOLOGICAL CHARACTERISTICS OF PATIENTS WITH KELOIDS TREATED WITH SURGICAL EXCISION, PRIMARY CLOSURE, AND ADJUVANT SUPERFICIAL RADIOTHERAPY AT LE HUU TRAC NATIONAL BURN HOSPITAL
Main Article Content
Abstract
Objective: To describe the clinical, histopathological, and ultrastructural characteristics of keloids in patients treated with surgical excision, primary closure, and adjuvant superficial radiotherapy.
Methods: A cross-sectional descriptive study was conducted on 49 patients with keloids who underwent treatment at Le Huu Trac National Burn Hospital between December 2022 and December 2025. Clinical characteristics, histopathological features, and ultrastructural changes of the lesions were analyzed.
Results: The mean age of the patients was 45.0 ± 17.4 years, and 67.3% were female. Fitzpatrick skin type IV was the most common (65.3%), while acne vulgaris was the leading cause of keloid formation (44.9%). Most lesions had been present for more than two years (79.6%), were predominantly located on the anterior chest (55.1%), exhibited a dark-red appearance (59.2%), and had a mean Japan Scar Workshop Scar Scale (JSS) score of 19.8 ± 2.0. Histopathological examination demonstrated significantly lower dermal papilla scores but greater epidermal thickness in the central region than in the peripheral region of the keloid (both p < 0.001). Ultrastructural analysis revealed significantly reduced desmosome length and hemidesmosome density in the central region (p < 0.001). Keloidal collagen was identified in all specimens, and collagen fibrils were significantly thicker in the central region than in the peripheral region in both the papillary and reticular dermis (p < 0.001).
Conclusion: Keloids were characterized clinically by prolonged duration, high biological activity, and a predilection for the anterior chest. Histopathological and ultrastructural analyses demonstrated characteristic alterations in the epidermis, basement membrane, and dermis, reflecting excessive collagen deposition and tissue remodeling.
Keywords
Keloid, Ultrastructure, Collagen, JSS
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References
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