A keloid scar differs from a hypertrophic scar primarily in that:
- A Keloid scars contain more type III collagen and resolve spontaneously over time
- B Hypertrophic scars have a higher recurrence rate after excision than keloids
- C Keloid scars extend beyond the boundaries of the original wound and do not regress spontaneously ✓
- D Keloids are confined to the face and scalp whereas hypertrophic scars occur elsewhere
Correct answer: C. Keloid scars extend beyond the boundaries of the original wound and do not regress spontaneously
Explanation
Keloid scars grow beyond the margins of the original wound into surrounding normal skin and rarely regress without treatment. Hypertrophic scars remain within the wound boundaries and often regress spontaneously over 1–2 years. Both contain type I and III collagen, but keloids have thickened collagen bundles with myofibroblast persistence. Keloids have a much higher recurrence rate after simple excision (up to 80–100%) and require adjuvant therapy (intralesional steroids, silicone gel, radiotherapy, or pressure). They are more common in darkly pigmented skin.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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