Investigations
1st investigations to order
clinical diagnosis
Test
Usually no tests are necessary.
Result
features of keloid
Investigations to consider
skin biopsy
Test
Rarely required and must be weighed against the risk of making the condition worse. The main reason to perform a skin biopsy is when there is doubt about the nature of the lesion (e.g., malignancy).[21] The most important differential diagnosis is dermatofibrosarcoma.
The need for histological examination following keloidectomy should be discussed with individual patients. The risk of misdiagnosis of other pathology as keloid scar has been estimated to be 1.06%.[22]
Result
elevated cellular proliferation at the margins of the scar but reduced cell density within the central portions; may also demonstrate increased extracellular matrix deposition; collagen fibres are typically larger and more irregular in arrangement than in normal scars; presence of hyalinised collagen in keloids
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