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Keloid in the lower abdomen. Removed by surgery and kenacot injection. Laser treatment done. Need permanent solution

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Practicing since : 2005
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sir, my wife aged 28yrs have facing large keloid (lower abdomen)since 4yrs and it was increasing day to was removed by surgery and kenacot inj was pushed but no result happened and then laser treatment was continue for 1yr but no result happen ie,when the treatment stop it size sir i need a permanent solution from your end
Surgical pathology report
specimen-swelling,mons pubis,excision.
clinical history-fibroma.
gross-received one skin covered tissue piece is wrinkled.cut surface pale white to light brown soft.(entire tissue;0000-69)
impression-swelling,mons pubis,excision;begins fibrous overgrowth.consistent hypertropic scar/ atypia/malignancy seen.
sir,above surgical operation was performed on08.09.2008 by surgeon of XXXXXXX XXXXXXX ,NRL,Golaghat,Assam & the pathology report from Eskay house,54 XXXXXXX Road,New Delhi0000.
After operation, kenacot inj.pushed for 3months & silicon sheet applied parallay then IPL+I/L Excert(laser ray) done throughout the that time it was just controlled.but now larger in size approx. 5x2cm & sometimes bleeding with pain.
Posted Sat, 2 Jun 2012 in Skin Hair and Nails
Answered by Dr. Sudarshan 3 hours later
Hi dear,

Thanks for your query.

In the beginning only I want to convey you that there is NO known cure for keloids that will totally cure the problem. Recurrence rates are high in keloid.
Whatever treatment modality is given for keloid recurrence may occur.

Some of the treatment that is effective and currently available in India are as follows.

Surgery — there is a 45% chance of recurrence after surgical removal. However, keloids are less likely to return if surgical removal is combined with other treatments.

Dressings — Moistened wound coverings made of silicone gel or silastic have been shown in studies to reduce keloid prominence over time. This is safe and painless option.

Steroid injections — a series of injections with triamcinolone acetonide or another corticosteroid may reduce keloid size and irritation.

Compression — Compression bandages applied to the site over several months, sometimes for as long as six to twelve months, may lead to a reduction in the size of the keloid.

Cryosurgery — Cryosurgery is an excellent treatment for keloids which are small and occur on lightly pigmented skin.

Radiation therapy- This is one of the more costly procedures.

Laser therapy —Pulse XXXXXXX laser and Co2 laser are effective in keloids.

As you have undergone a no. of treatments including surgery, my advice to you would be

1. cryotherapy with liquid nitrogen with either cryospray or Intra lesional cryotherapy.
2. Followed by intralesional steroid and 5 Flurouracil in combination.
3. Along with compression therapy.

This kind of combination therapy would be needed.
Intermittent sitting of Co2 laser or Pulsed XXXXXXX laser would be needed to decrease the bulk and symptoms of keloid.

A good dermatosurgeon can provide you the options mentioned above.

Hope I’ve answered your query.

If you need any further clarification please let me know.

Dr Sudarshan
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