PMC3677673_01
A case of severe keloids with hypertension. This 63-year-old woman started to develop keloids on her trunk and upper limbs when she was an elementary school student. During her first examination in our clinic, her blood pressure was found to be 150/95 (stage I hypertension: JNC7).
eplasty13e25_fig1.jpg
PMC3677673_01_eplasty13e25_fig1.jpg
F1
This 63-year-old woman started developing keloids on her trunk and upper limbs when she was an elementary school student (Fig 1). Interestingly, the remaining keloids also seemed to have improved, particularly the keloids on her right chest (Fig 4): there was considerably less redness and elevation compared to when she first presented (Fig 1), even though these keloids had not been treated directly in any way.
Surgical treatment with radiation adjuvant therapy of scar contractures caused by severe keloids. A distally based radial artery flap was selected for the thumb and wrist. Starting on the day after surgery, both the donor and recipient sites were subjected to 4 MeV electron beam irradiation (15 Gy/3 fractions for 3 days).
eplasty13e25_fig2.jpg
PMC3677673_01_eplasty13e25_fig2.jpg
F2
A distally based radial artery flap was selected for the thumb and wrist joints (Fig 2), and simple excision and suture were selected for the elbow joint.
Two-year postoperative view. The range of motion of all joints recovered fully, and there was no recurrence of the keloids or scar contractures.
eplasty13e25_fig3.jpg
PMC3677673_01_eplasty13e25_fig3.jpg
F3
Two years after the surgical and postoperative radiation therapy, the scar contractures had been released completely and keloid recurrence was not observed (Fig 3).
Captopril treatment may have changed the objective symptoms of the remaining keloids. The patient started taking captopril after her first examination and was still taking it at the 2-year postoperative visit. Compared to when she first presented (see Fig 1), the objective symptoms of her remaining keloids (which were not treated directly in any way) seemed to be decreased. In particular, the redness and elevation of the keloids on her right chest were dramatically decreased compared to 2 years ago (Fig 1).
eplasty13e25_fig4.jpg
PMC3677673_01_eplasty13e25_fig4.jpg
F4
Interestingly, the remaining keloids also seemed to have improved, particularly the keloids on her right chest (Fig 4): there was considerably less redness and elevation compared to when she first presented (Fig 1), even though these keloids had not been treated directly in any way.