Dr Hom is to be congratulated for his extensive review of the current and historical literature on this topic. The keloid represents a challenging wound-healing dilemma, lacking uniform treatment guidelines. Clinical experience, compounded by the findings of a variety of clinical series, confirms the lack of a foolproof protocol in treating this form of scar. The keloid is an abnormal tissue response to trauma in which fibroblasts deposit an overabundance of collagen, fibronectin, and extracellular matrix. The ensuing cicatrix is composed of randomly aligned collagen bundles that grow beyond the boundaries of the original wound.
Thomas JR. Keloids Should Be Treated With the Traditional Scalpel Incision Followed by Steroid Injection. Arch Otolaryngol Head Neck Surg. 2001;127(9):1144. doi:10.1001/archotol.127.9.1144