Papers of The 4th Japan Scar Workshop

24. Analysis of regions where keloids tend to occur

Yasutaka Omori, Satoshi Akaishi, Rei Ogawa, Hiko Hyakusoku
Department of Plastic and Reconstructive Surgery, Nippon Medical School, Tokyo, Japan

Keloids are considered to most likely occur in the precordial region, scapular region and pubic region, but the statistical details are not clear. So, we extracted keloids caused by small stimuli (idiopathic, acne vulgaris, minor trauma). The purpose of this study was to create a distribution map of keloids.
A total of 1034 keloids of 362 patients (227 males ,135 females, average age 32.4 years) were studied. The causes were 211 idiopathic , 652 acne vulgaris and 171 minor trauma (such as insect bites, traumas of the bra hook and vaccination). Judging from these clinical photographs, we created a distribution map of keloids of the whole body. We excluded cases of keloids that were multiple and fused and had obvious causes (surgeries, and so on).
The sites of occurrence of 1034 keloids were 101 facial parts , 487 precordial regions, 1 side chest, 361 scapular regions, 3 upper abdomen areas, 16 lower abdomen areas, 9 dorsal areas , 35 brachial regions, 6 antebrachial regions, 12 femoral regions and 3 leg regions. A lot of them occurred especially in the precordial regions and scapular regions. There were significant differences in the distributions between the precordial regions and side chest, upper abdomen areas and lower abdomen areas. In addition, in the distribution of arm and lower leg, it was clear that the density of distribution dropped as it was far from the body trunk.
We created a distribution map of where keloids tend to occur. The favorite sites were mostly the same although there were few differences by cause of keloids. In the body trunk, developmental distribution was clearly biased at the site of high tension, so we could reaffirm the relationship between the tension on the skin and favorite sites.
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