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September 2003
By Youn W. Park, MD, and Mark Matthews,
MD
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CASE:
A 21-year-old black woman has been referred for a tumor of
the ear lobule. She denies any pain or bleeding.
WHAT IS YOUR DIAGNOSIS?
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Keloids occur rather frequently in the lobules of pierced ears
among blacks and other genetically susceptible individuals.
As a result of trauma or surgery, a massive collection of collagen
bundles develops in a random organization, interspersed with
active fibroblasts. Possible approaches include laser treatment,
interferon, and postoperative low-dose irradiation to destroy
fibroblasts. A more traditional treatment involves atraumatic
surgical excision accomplished with an intralesional injection
of triamcinolone, sometimes in combination with hyaluronidase.
Complete eradication is difficult to achieve by any means. |
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Dr. Park is a clinical professor of otolaryngology
at Northeastern Ohio Universities College of Medicine and
section head of otolaryngology at Barberton Citizens Hospital
in Barberton, Ohio. Dr. Matthews is an attending physician
in the department of family practice at Barberton Citizens
Hospital.
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