<prompt> The following statement about keloid is true:Elevated levels of growth factor is not seenExtended excision is the treatment of choiceIt do not extend beyond the woundIt will have more collagen and vascularity  <response>: Feature Hyperophic Scar Keloid Genetic Not FamilialQ May be familialQ Race Not race relatedQ BlackQ white Sex Female male FemaleQ male Age ChildrenQ 10-30 yearsQ Border Remains within woundQ Outgrows wound area Natural history Subsides with time Rarely subsides Site Flexor surfacesQ Stemum MCQ, shoulder, face Etiology Related to tensionQ Unknown Develop Within 4 weeks 3Months to years after trauma Symptoms Raised some pruntus Respect wound confines Pain, pruritus, hyperesthesia Growth beyond wound margins Histology Parallel orientation of collagen fibers Thick wavy collagen fibers in random orientation Treatment: Keloid Hyperophic Scar First line: silicone pressure therapy IL inj.Triamcinolone Linear HTS - Pressure therapy or Silicone gel sheet Refractory: Excision Post -op RthEB or Brachytherapy Ongoing Hyperophy - Intralesional inj. Triamcinolone 1 year - Excision closure 