Radiotherapy for Recurrent Keloid: A Case Report

*Christina Hari Nawangsih Prihharsanti  -  Faculty of Medicine, Diponegoro University, Indonesia
Muhamad Rizqi Setyarto  -  Kariadi General Hospital, Indonesia
Dion Firli Bramantyo  -  Kariadi General Hospital, Indonesia
Received: 18 Jul 2020; Revised: 22 Dec 2020; Accepted: 20 Oct 2020; Published: 31 Dec 2020; Available online: 31 Dec 2020.
Open Access
Citation Format:
Abstract

Background: Keloid is a benign growth of connective tissue. There are several risk factors that play a role in keloid growth. Excision surgery is one of the modalities in the treatment of keloids. However, excision surgery alone has a recurrence rate of 45-100%.

Case: Male, 37 years old, with complaints arising from a keloid lesions in the left earlobe since three years ago with a history of previous injuries. The lesions is then operated on but always grows back postoperatively. The number of surgeries that have been carried out three times with further treatment in the form of corticosteroid injection. However, keloid still recurrence. Finally it was decided to undergo treatment with surgery followed by radiotherapy within a period of no more than 24 hours postoperatively. Follow-up after six months gave good results without recurrence.

Discussion: Keloid has a high recurrence rate after excision surgery. Surgery followed by radiotherapy has a low recurrence rate compared to surgery or surgery followed by administration of corticosteroid injections. Radiotherapy as adjuvant therapy for postoperative keloid excision has the role of sterilizing the connective tissue stem cell active fibroblasts and acute inflammatory cells that grow in the early postoperative period. A study states that administration of postoperative radiation with electrons in keloids in the earlobe at a dose of 15 Gy in three fractions gives a low recurrence rate and a low risk of side effects in the surrounding soft tissue.

 

Keywords: keloids; recurrence; radiotherapy.

Article Metrics:

Article Info
Section: Case Reports
Language: EN
In Vol 6, No 3 (2020): December2020
Statistics: 166 128
Others articles
Active Cytomegalovirus Infection in Critically Ill Immunocompeten Patients Admitted in the ICU. A Molecular Diagnosis Approach Classification, nosology and diagnostics of Ehlers-Danlos syndrome Factors Affecting Parents' Acceptance towards Children with Familial Intellectual Disability (ID) Expression of p53 and Bcl2 Mammary Adenocarcinoma in C3H Mice Administered With Salvia miltiorrhizae Bunge root extract Effect of Nigella Sativa on IL-10 in MB Leprosy that Received MDT-WHO Therapy Cytogenetic Analysis and Clinical Phenotype of Primary Amenorrhea in Indonesian Patients
  1. Flickinger J C. A Radiobiological Analysis of Multicenter Data for Postoperative Keloid Radiotherapy. Radiat Oncol Biol [Internet]. Elsevier Ltd; 2011;79(4):1164–70. Available from: http://dx.doi.org/10.1016/j.ijrobp.2009.12.019
  2. Jones K, Fuller CD, Luh JY, Childs CC, Miller AR, Tolcher AW, et al. BMC Dermatology Case report and summary of literature : giant perineal keloids treated with post-excisional radiotherapy. BMC Dermatology7. 2006;6:1–6
  3. Shaheen A. Risk Factors of Keloids : A Mini Review Risk Factors of Keloids : A Mini Review. Austin J Dermatology. 2017;4(2):1–5
  4. Shaheen A, Khaddam J, Kesh F. Risk factors of keloids in Syrians. BMC Dermatol [Internet]. BMC Dermatology; 2016;16(13):1–11. Available from: http://dx.doi.org/10.1186/s12895-016-0050-5
  5. Lei-ming Sun, Kuo-hsien Wang YGL. Keloid incidence in Asian people and its comorbidity with other fibrosis-related diseases : a nationwide population-based study. Arch Dermatol Res. 2014;306:803–8
  6. Mustoe, Thomas A; Cooter Retney D; Gold, Michael H; Hoobs F. D. Richards; Ramelet, Albert-Andrien; Shakespeare PG. et al. Keloid International Clinical Recomendation.pdf. Plast Reconstuctive Surg. 2002;110:560–71
  7. Dinh Q, Veness M, Richards S. Role of adjuvant radiotherapy in recurrent earlobe keloids. Aust J Dermatol. 2004;45:162–6
  8. Ogawa R, Mitsuhashi K, Hyakusoku H MT. Postoperative electron-beam irradiation therapy for keloids and hypertrophic scars: retrospective study of 147 cases followed for more than 18 months. Plast Reconstuctive Surg. 2003;111(2):547–53
  9. Shen J, Lian X, Sun Y, Wang X, Hu K, Hou X, et al. Hypofractionated electron-beam radiation therapy for keloids : retrospective study of 568 cases with 834 lesions. J Radiat Res. 2015;56(5):811–7
  10. Mankowski P, Kanevsky J, Tomlinson J, Dyachenko A, Luc M. Optimizing Radiotherapy for Keloids. Ann Plascic Surg. 2017;78(4):403–11
  11. Kim K, Son D, Kim J. Radiation Therapy Following Total Keloidectomy: A Retrospective Study over 11 Years. Arch Plast Surg. 2015;24(5):588–95

Last update: 2021-04-17 15:10:15

No citation recorded.

Last update: 2021-04-17 15:10:15

No citation recorded.

The Authors submitting a manuscript do so on the understanding that if accepted for publication, copyright of the article shall be assigned to Journal of Biomedicine and Translational Research Diponegoro University as publisher of the journal.

Copyright encompasses exclusive rights to reproduce and deliver the article in all form and media, including reprints, photographs, microfilms and any other similar reproductions, as well as translations. The reproduction of any part of this journal, its storage in databases and its transmission by any form or media, such as electronic, electrostatic and mechanical copies, photocopies, recordings, magnetic media, etc., will be allowed only with a written permission from Journal of Biomedicine and Translational Research Diponegoro University.

Journal of Biomedicine and Translational Research Diponegoro University, the Editors and the Advisory International Editorial Board make every effort to ensure that no wrong or misleading data, opinions or statements be published in the journal. In any way, the contents of the articles and advertisements published in the Journal of Biomedicine and Translational Research Diponegoro University (JBTR) are sole and exclusive responsibility of their respective authors and advertisers.

The Copyright Transfer Form can be downloaded here: [Copyright Transfer Form JBTR] 

The copyright form should be signed originally and send to the Editorial Office in the form of original mail, scanned document or fax :  
Journal of Biomedicine and Translational Research Faculty of Medicine, Diponegoro University
Jl. Prof. Soedarto, Kampus UNDIP Tembalang, Semarang, Central Java, Indonesia 50275, Telp.: +62-24-8412311, Fax.: +62-24-8454714
Email: jbtr@fk.undip.ac.id and jbtr@live.undip.ac.id