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Clinical Implications of Single- Versus Multiple-Site Keloid Disorder

A Retrospective Study in an Asian Population

Park, Tae Hwan MD*†; Park, Ji Hae MD*; Tirgan, Michael H. MD; Halim, Ahmad Sukari MD, PhD; Chang, Choong Hyun MD, PhD*

doi: 10.1097/SAP.0b013e3182a2b537

Background There is strong evidence of genetic susceptibility in individuals with keloid disorder. The purpose of this cross-sectional study was to determine the clinical relevance of our proposed variables on the multiplicity of keloids by further investigating the presence of other keloids and a family history.

Methods This was a retrospective review, using institutional review board–approved questionnaires, of patients with keloids who were seen at Kangbuk Samsung Hospital between December 2002 and February 2010. Eight hundred sixty-eight patients were included in our study. Comparisons between the 2 groups were made using Mann-Whitney tests for continuous variables and χ2 tests for categorical variables.

Results In our patient group, younger age of onset and the presence of family history were significantly associated with the occurrence of keloids at multiple sites. The locations of extra-auricular keloids, in order of frequency, included the shoulder; anterior chest, including the breasts; deltoid; trunk and pubic area; upper extremities; lower extremities; and other sites. As compared to secondary keloids, primary keloids were significantly associated with both a lower degree of recurrence and the presence of other keloids. The presence or absence of family history was significantly associated with the presence or absence of other keloids and primary or secondary keloids.

Conclusions Keloid disorder is one of the most frustrating problems in wound healing and advances in our understanding of the differences of occurrence at a single site versus multiple sites might help in understanding pathogenesis and improving treatment.

From the *Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; †Keloid Research Foundation, New York, NY; and ‡Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.

Received June 11, 2013, and accepted for publication, June 27, 2013.

Conflicts of interest and sources of funding: none declared.

Reprints: Choong Hyun Chang, MD, PhD, Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyung-Dong, Jongno-Gu, Seoul 110-746, Korea. E-mail:

The authors Tae Hwan Park and Ji Hae Park contributed equally to this work.

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