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Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis
Keloids are caused by excessive scar formation that leads to scar growth beyond the initial scar boundaries. Keloid formation and progression is promoted by mechanical stress such as skin stretch force. Consequently, keloids rarely occur in paralyzed areas and areas with little skin tension, such as...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548580/ https://www.ncbi.nlm.nih.gov/pubmed/28831357 http://dx.doi.org/10.1097/GOX.0000000000001417 |
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author | Aoki, Masayo Akaishi, Satoshi Matsumoto, Noriko M. Tsuge, Takuya Kubomura, Ken Nishikawa, Midori Nomoto, Shunichi Ogawa, Rei |
author_facet | Aoki, Masayo Akaishi, Satoshi Matsumoto, Noriko M. Tsuge, Takuya Kubomura, Ken Nishikawa, Midori Nomoto, Shunichi Ogawa, Rei |
author_sort | Aoki, Masayo |
collection | PubMed |
description | Keloids are caused by excessive scar formation that leads to scar growth beyond the initial scar boundaries. Keloid formation and progression is promoted by mechanical stress such as skin stretch force. Consequently, keloids rarely occur in paralyzed areas and areas with little skin tension, such as the periauricular region. Therefore, periauricular incision is commonly performed for face lifts. We report a rare case of keloids that arose from face-lift scars in a patient with bilateral facial nerve paralysis. A 51-year-old Japanese man presented with abnormal proliferative skin masses in bilateral periauricular scars. Seventeen years before, he had a cerebral infarction that resulted in permanent bilateral facial nerve paralysis. Three years before presentation, the patient underwent face-lift surgery with periauricular incisions. We diagnosed multiple keloids. We removed the masses surgically, closed the wounds with sutures in the superficial musculoaponeurotic system layer to reduce tension on the wound edges, reconstructed the earlobes with local skin flaps, and provided 2 consecutive days of radiotherapy. The wounds/scars were managed with steroid plasters and injections. Histology confirmed that the lesions were keloids. Ten months after surgery, the lesions did not exhibit marked regrowth. The keloids appeared to be caused by the patient's helmet, worn during his 3-hour daily motorcycle rides, which placed repeated tension on the periauricular area. This rare case illustrates how physical force contributes to auricular and periauricular keloid development and progression. It also shows that when performing surgery with periauricular incisions, care should be taken to eliminate wound/scar stretching. |
format | Online Article Text |
id | pubmed-5548580 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-55485802017-08-22 Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis Aoki, Masayo Akaishi, Satoshi Matsumoto, Noriko M. Tsuge, Takuya Kubomura, Ken Nishikawa, Midori Nomoto, Shunichi Ogawa, Rei Plast Reconstr Surg Glob Open Case Report Keloids are caused by excessive scar formation that leads to scar growth beyond the initial scar boundaries. Keloid formation and progression is promoted by mechanical stress such as skin stretch force. Consequently, keloids rarely occur in paralyzed areas and areas with little skin tension, such as the periauricular region. Therefore, periauricular incision is commonly performed for face lifts. We report a rare case of keloids that arose from face-lift scars in a patient with bilateral facial nerve paralysis. A 51-year-old Japanese man presented with abnormal proliferative skin masses in bilateral periauricular scars. Seventeen years before, he had a cerebral infarction that resulted in permanent bilateral facial nerve paralysis. Three years before presentation, the patient underwent face-lift surgery with periauricular incisions. We diagnosed multiple keloids. We removed the masses surgically, closed the wounds with sutures in the superficial musculoaponeurotic system layer to reduce tension on the wound edges, reconstructed the earlobes with local skin flaps, and provided 2 consecutive days of radiotherapy. The wounds/scars were managed with steroid plasters and injections. Histology confirmed that the lesions were keloids. Ten months after surgery, the lesions did not exhibit marked regrowth. The keloids appeared to be caused by the patient's helmet, worn during his 3-hour daily motorcycle rides, which placed repeated tension on the periauricular area. This rare case illustrates how physical force contributes to auricular and periauricular keloid development and progression. It also shows that when performing surgery with periauricular incisions, care should be taken to eliminate wound/scar stretching. Wolters Kluwer Health 2017-07-25 /pmc/articles/PMC5548580/ /pubmed/28831357 http://dx.doi.org/10.1097/GOX.0000000000001417 Text en Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Case Report Aoki, Masayo Akaishi, Satoshi Matsumoto, Noriko M. Tsuge, Takuya Kubomura, Ken Nishikawa, Midori Nomoto, Shunichi Ogawa, Rei Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis |
title | Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis |
title_full | Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis |
title_fullStr | Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis |
title_full_unstemmed | Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis |
title_short | Periauricular Keloids on Face-Lift Scars in a Patient with Facial Nerve Paralysis |
title_sort | periauricular keloids on face-lift scars in a patient with facial nerve paralysis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548580/ https://www.ncbi.nlm.nih.gov/pubmed/28831357 http://dx.doi.org/10.1097/GOX.0000000000001417 |
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