Keloid scars differ from hypertrophic scars in a key clinically important way. Which statement is MOST accurate?
- A Keloids extend beyond original wound margins and do not regress spontaneously, unlike hypertrophic scars ✓
- B Hypertrophic scars extend beyond the original wound margins while keloids do not
- C Keloids only form in areas of high skin tension like joints
- D Hypertrophic scars are more common in dark-skinned individuals than keloids
Correct answer: A. Keloids extend beyond original wound margins and do not regress spontaneously, unlike hypertrophic scars
Explanation
Keloids extend beyond the original wound margins (unlike hypertrophic scars which stay within), do not regress spontaneously, and have a high recurrence rate after excision. They are more common in darker-skinned individuals and characteristically occur on the earlobes, sternum, deltoid region, and upper back. Hypertrophic scars remain within wound boundaries, often form in areas of skin tension, and may regress over 12-18 months. Treatment of keloids includes intralesional corticosteroids, silicone gel, pressure therapy, and careful excision with adjuvant treatment.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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