Fresh keloids consist of dense bundles of collagenous fibrils and an ample mucinous ground substance with a high content of mucopolysaccharides. Mast cells and fibroblasts are present in large numbers. Keloids of longer standing are less cellular, with fibril bundles predominating, whereas the ground substance is less ample.
Since cortisone and hydrocortisone are known to influence the chemistry and morphology of connective tissue cells and to inhibit their production of intercellular substance,1 it is reasonable to expect that keloids would be susceptible to treatment with adrenocortical steroids.
In patients with Cushing's syndrome wounds and scars are apt to become distended. This is also observed in patients on systemic treatment with corticotropin (ACTH) and cortisone. In such patients softening of keloids has been noted as well.* This effect is, however, too slight and undependable to acquire any therapeutic importance. A more marked effect must be expected