Journal of Cosmetics, Dermatological Sciences and Applications, 2013, 3, 30-31
Published Online November 2013 (http://www.scirp.org/journal/jcdsa)
http://dx.doi.org/10.4236/jcdsa.2013.33A2007
Open Access JCDSA
Original Support of an after Piercing Lobular Keloid
Scar: About a Case
Christiane Koudoukpo1, Hugues Adé gb i di2*, Spéro Raoul Hounkpatin1, Félix Atadokpèdé2,
Julienne Téclessou2, Fabrice Akpadjan2, Bérénice Dégboé-Sounhin2, Hubert G. Yédomon2
1Faculté de Médecine de Parakou, Université de Parakou, Parakou, Bénin; 2Faculté des Sciences de la Santé de Cotonou, Université
d’Abomey-Calavi, Cotonou, Bénin.
Received September 10th, 2013; revised October 8th, 2013; accepted October 16th, 2013
Copyright © 2013 Christiane Koudoukpo et al. This is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
Keloids are tissue repair formed by exuberant fibrosis appearing after a skin wound, burn, vaccination or post inflam-
matory (folliculitis or acne lesion). This condition causes standard aesthetic prejudice to those who are affected. Its
management is difficult and its evolution meshes recurrences. We report here a case of giant keloid in the right ear lobe
after a piercing and its support.
Keywords: Piercing Lobular Keloid Scar
1. Introduction
Keloids are tissue repair formed by exuberant fibrosis
appearing after a skin wound, burn, vaccination or post
inflammatory (folliculitis or acne lesion). We report a
case of giant keloid in a right ear lobe piercing and its
support.
2. Observation
A 28 years old dark-skinned woman consulted in June
2011 for an asymptomatic tumoral lesion of the right ear
lobe evolving since November 1999. The injury occurred
after a piercing. In his history, we noted two attempts of
complete surgical excision of the keloid lesion without
further treatment associated, but with recurrence after
each removal. Clinical examination revealed an oval nor-
mochromic tumoral lesion, pedicle based with normal
surface appearance measuring 6 cm × 4.5 cm large, sit-
ting at the base of the right ear lobe. This is attached at
the extreme left to a rounded bead keloid about 1 cm
diameter with normal surface and sharp boundaries (Fig-
ure 1). Surgical resection was then performed under lo-
cal anesthesia after infiltration of lidocaïne (Xylocaine®
2%). The procedure consisted in an incision made in the
keloid area at the edg e of healthy skin, excision with was
intra keloid, but very close to the health y zone, keeping a
thin rim of keloidal tissue. The suture was performed
with absorbable suture (4 - 0), point by point in a plane
substantially keloid area, then left in open air, without
dressing. Touching Povidone-iodine (Betadine® dermal)
two times a day, followed by application of be-
tamethasone dipropionate (Diprosone® cream) once a
day under occlusion at least 12 hours per day from the
fifth day of action were recommended. The occlusion
dressing was continued for 6 weeks. There is no com-
plaint or recurrence 24 months after the cessation of any
treatment (Figure 2).
3. Discussion
The clinical diagnosis of keloid is the appearance of hard
tumor mass after trauma, infection or spontaneously [1].
Keloïd used to grow, have no tendency for spontaneous
regression. This condition differs from hypertrophic scar
which is limited to the site of the original skin wound,
occurring before a three months period and has a ten-
dency to spontaneous regression [2]. One of the great
problems of the treatment of keloids is that they tend to
recur if we proceed with surgical resection, and some-
times more important. When the surgery is done, it is
usually associated with other treatments (pressure therapy,
corticosteroids, radiation). The first therapeutic choice of
*Corresponding author.

Original Support of an after Piercing Lobular Keloid Scar: About a Case 31
Figure 1. Showing the giant lobular keloid.
Figure 2. After surgeon and topical steroids under occlusion
treatment.
doctors is often intra-lesional injection s of corticosteroids.
This improves the appearance of the lesio n, but often not
enough to make it disappears. The best results are ob-
tained on the keloid neck and ear lobes, the worst on the
chest. It can persist a residual coloration of the skin after
treatment [3]. The therapeutic approa ch used in our clini-
cal case is not described in the literature for this localiza-
tion. Intra lesional infiltration after partial or total exci-
sion is described in the literature, giving variable results
depending on the localizations of lesions. In lobular
keloids, the result is better but poor on other areas [3].
This poor outcome in non-lobular keloids may be due to
irritation at the injection site promoting recurrence. The
absorption of topical corticosteroid is increased by oc-
clusion and gave the favorable evolution of our patient:
this therapeutic app roach could be proposed in the th era-
peutic support of lobular keloids. It has the advantage of
avoiding the pain associated with post excision intrale-
sional infiltration.
4. Conclusion
The treatment of keloids is necessary to the existence of
disabling functional signs, mechanical discomfort and
unsightly damage. The interest of this case involves sur-
gical excision with topical steroids under occlusion to
spare patients the pain of post resection and intra-lesional
injections. This therapeutic approach deserves to be
known.
REFERENCES
[1] S. O. Niang, A. A. Sankale, F. Fall, et al., “The Role of
Surgery in the Treatment of Keloids in Dakar,” Médecine
d’Afrique, Vol. 56, No. 4, 2009, pp. 224-226.
[2] T. A. Mustoe, R. D. Cooter, M. H. Gold, et al., “Recom-
mendations on the Clinical Support of Scars,” Journal des
Plaies et Cicatrisations, Vol. 34, 2002, pp. 7-16.
[3] I. Bodokh, “Therapeutic Support of Keloids,” EMC Cos-
métologie et Dermatologie Esthétique, 50-460-A10, 2003,
6p.
Open Access JCDSA