Hypertrophic scars differ from keloids in several important ways. Which statement correctly distinguishes them?
- A Keloids regress spontaneously over 12–18 months; hypertrophic scars do not
- B Keloids are more common in fair-skinned individuals; hypertrophic scars in darker skin
- C Hypertrophic scars remain confined to the original wound boundaries; keloids extend beyond them ✓
- D Hypertrophic scars contain more type I collagen organised parallel to the skin surface
Correct answer: C. Hypertrophic scars remain confined to the original wound boundaries; keloids extend beyond them
Explanation
The key distinguishing feature: hypertrophic scars are raised but remain within the confines of the original wound, often regress with time (6–24 months), respond to compression therapy, and can occur in all skin types. Keloids extend beyond the original wound margins (tumour-like growth), do not regress, are more common in darker skin (Fitzpatrick III–VI), have higher recurrence after excision, and require multimodal treatment (excision with adjuvant radiotherapy or steroid injection).
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
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