A 30-year-old woman develops a raised, itchy, erythematous scar that extends BEYOND the boundaries of the original wound on her shoulder 6 months after a minor surgical excision. This is MOST consistent with:

• A Hypertrophic scar — raised but confined within wound margins
• B Contracture scar across a flexion joint
• C Marjolin's ulcer — malignant transformation within a chronic scar
• D Keloid — raised scar extending beyond original wound margins, more common in pigmented skin, does not regress spontaneously ✓

Explanation

Keloids are pathological scars defined by their extension beyond the margins of the original wound, unlike hypertrophic scars which remain within the wound boundaries. Keloids are more common in individuals with darker skin pigmentation (Fitzpatrick types IV–VI), preferentially occur on the chest, shoulders, earlobes, and jawline, do not regress spontaneously, and may recur after excision. Treatment options include intralesional corticosteroids, pressure therapy, silicone gel, and radiotherapy. Hypertrophic scars may improve with time.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.