Familial and sporadic keloid presentation and management outcomes

Abstract

Background: Keloids are dermato-fibro-proliferative disorders characterized by excessive collagen deposition in the dermal layer.While most keloids occur sporadically, familial aggregation of keloids has also been noted.
Objective: To determine the clinical presentation and management outcomes of familial and sporadic keloids among patientsat Kenyatta National Hospital.
Design: This was a longitudinal prospective comparative study
Setting:Kenyatta National Hospital, Nairobi, Kenya
Subjects/Participants: Patients presenting with keloidswere classifiedinto familialor sporadic groups based on the family history of the disease.
Results: A total of 90 patients with 121 keloids were seen.Male to female ratio for the sporadic group was1:3while the ratio was 1:1 for the familial group (p-value0.001). Themost common anatomical site for keloids in both groups were the ears with the second most common site being the cheeks for the familial group and abdomen for the sporadic group (p-value0.05). Sixty percent of familial keloidspresented with pain compared to 42% of the sporadic group (p-value 0.001). Ninety eight percent (98%)of familial keloids presented with pruritus compared to 61%of sporadic keloids(p-value 0.001). The recurrence rate was 26.9% for familial keloids compared to 18.5% for the sporadic keloid group(p-value0.026).
Conclusion: This study demonstrates that patients with familial keloids have a high pain and pruritus prevalence as well as a high recurrence rate, and therefore amore severe disease in comparison to the sporadic keloids patients.This suggests that familial keloid patients need a more aggressive management strategy compared to the sporadic group.