title: Description of site-specific morphology of keloid phenotypes in an Afrocaribbean population.
abstract: By examining the keloid scars of 211 Afrocaribbean patients presenting to the Plastic Surgery unit in Kingston, Jamaica, we have described site-specific morphologies of scarring; keloid disease is not a homogenous biological entity. All cases conformed to clinical criteria for diagnosis of keloid scarring: 369 keloid scars were present in 137 females (2-83 years; mean 29.6 years; SD+/-14.9 years) and 74 males (5-90 years, mean 29.5 years; SD+/-15.0 years). Morphologies were specific to each anatomical site: trunk scars (n=45,12.1%) were geometrically shaped with clear margins or irregular in outline, surface and margin; back single scars were well-demarcated botryoid but multiple scars were butterfly-shaped, spheroidal and irregular; chest scars (n=72,20.1%) were butterfly or nonbutterfly shaped found most commonly in the midsternal line; upper limb scars (n=57,15.3%) mostly in the deltoid region (propeller shaped) or elsewhere nodular, linear to irregular; ear (n=85,23%) commonest site being the lobe, having reniform to bulbous shape; face and neck (n=60,16.2%) scars were firm nodular to hard; posterior auricular scars were either horizontal and oblong-shaped or vertical and reniform in outline; scalp scars (n=11,2.8%) were commonest in the occipital area varying from small papules to large plaques; lower limb scars (n=39,10.5%) varied from propeller, butterfly, petalloid to dum-bell-shaped. Three plantar and eight pubic keloids were rare findings. Recognition of different morphological phenotypes is necessary in understanding genotypic predisposition and aiding diagnosis, treatment and prognosis of keloid scars.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of West Indies, Mona, Kingston, Jamaica. ardeshir.bayat@man.ac.uk
authors.forename: A
authors.initials: A
authors.lastname: Bayat
authors.forename: G
authors.initials: G
authors.lastname: Arscott
authors.forename: W E R
authors.initials: WE
authors.lastname: Ollier
authors.forename: M W J
authors.initials: MW
authors.lastname: Ferguson
authors.forename: D A
authors.initials: DA
authors.lastname: Mc Grouther
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D044383:Black People; D002648:Child; D002675:Child, Preschool; D004739:England; D005260:Female; D006801:Humans; D007563:Jamaica / Q000208:ethnology; D007627:Keloid / Q000208:ethnology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity