Surgical treatment of ear keloids

The authors report the outcomes of patients with auricular keloid scars treated with a protocol of extralesional excision and postoperative electron-beam irradiation therapy. The design of the study was a retrospective analysis of between 1988 and 2000. All ear keloids were divided into earlobe and non-earlobe keloids. (The area of the earlobe was defined by drawing a horizontal line at the lowest point of the intertragic notch to the lobular baseline. Earlobes were classified into three types according to the angle formed between the face and the area of attachment of the earlobe.) Fifty-two keloid scars in 33 patients were treated (79 percent female patients; 100 percent Japanese; 83 percent of keloids were located on earlobes). The average age of subjects was 23.3 years (range: 4 to 43 years). There was a minimum of 14 months' follow-up in all cases. Statistical analysis was performed using Fisher's exact probability test. The total recurrence rate was 37.5%, and there were significant differences in recurrence rates related to the shape of the earlobes (the papering type earlobe had a low recurrence rate against the square type and the pendulous type) (4.55% vs. 23.3%; p=0.00884). There were no differences in the part and the cause of keloid. Long-term follow up of patients with ear keloids is considered necessary. (author)