Case history
Case history
An 18-year-old woman with a history of acne presents with a 20 × 15 mm raised, firm, pink swelling on her right upper back. This has been slowly growing for more than 1 year. She has also noticed a new smaller swelling, also pink and firm, developing in the adjacent skin. She already has 2 similar lesions, which developed on her left upper arm after vaccinations she received when she entered high school. These grew for about 2 years, but there has been no subsequent change in their size. Occasionally, they itch or she experiences a sharp, needle-like pain. She has never sought treatment before but is now self-conscious as she is hoping to wear a low-cut dress for her older sister's wedding. [Figure caption and citation for the preceding image starts]: Elevated, red, smooth, nodule of scar tissue; arose in the site of an acne lesion that had been squeezedFrom the collection of Professor Andrew Burd, used with permission [Citation ends].
[Figure caption and citation for the preceding image starts]: Red, elevated keloid; edges blend into the surrounding skin; arose in a vaccination site in the left upper armFrom the collection of Professor Andrew Burd, used with permission [Citation ends].
Other presentations
Typically, keloid scarring occurs after an inciting event such as trauma, surgery, body piercing, vaccination (in the deltoid region), or acne on the back or chest. However, it may occur on any part of the body in susceptible individuals.[Figure caption and citation for the preceding image starts]: An extensive keloid has been previously excised and the defect skin grafted; keloid scarring has subsequently developed at the peripheriesFrom the collection of Professor Andrew Burd, used with permission [Citation ends].
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