title: Plantar keloids: diagnostic and therapeutic issues in six patients.
abstract: BACKGROUND
  Keloids are benign fibro-proliferative skin lesions that very rarely occur on the soles. Because of their rarity, the diagnosis of plantar keloids can be difficult. We describe the clinical and histopathological characteristics of eight plantar keloids.
  
  
  METHODS
  All patients presenting with plantar keloids between 2005 and 2012 in our Dermatology unit were retrospectively included. Diagnosis was definitely established by re-reading of pathological slides in all cases. Clinical characteristics, histopathological features, treatments given and their results were collected.
  
  
  RESULTS
  Six patients were included. Five patients had a single plantar keloid and one had three lesions. They all were of African descent. Only one patient remembered of a previous injury at the site of the keloid. Three patients presented with associated extra-plantar keloids. In four patients, the diagnosis of keloid was not initially suspected clinically or histologically. Re-reading of the clinical photographs showed that the eight plantar keloids shared common morphological features, leading to a distinctive clinical picture, defined by a hardened lesion of rounded or polycyclic shape, with a pink surface crossed by keratotic furrows and the presence of a hyperkeratotic rim. Concerning pathological features, typical hyalinized collagen can be missing and deep fibrosis should not rule out the diagnosis of keloid. Intralesional injection of triamcinolone acetonide and orthopaedic shoes were useful. All patients who had surgical excision presented recurrence.
  
  
  CONCLUSIONS
  The knowledge of the clinical features of plantar keloids is helpful to the diagnosis. There is no well-established treatment, but supportive measures are important.
authors.affiliation: Service de Dermatologie, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Vanhaecke
authors.affiliation: Service de Dermatologie, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Hickman
authors.affiliation: Service d'Anatomie Pathologique, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Cavelier-Balloy
authors.affiliation: Service de Chirurgie plastique, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Masson
authors.affiliation: Service de Chirurgie plastique, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: J-B
authors.initials: JB
authors.lastname: Duron
authors.affiliation: Service de Chirurgie plastique, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Gorj
authors.affiliation: Service de Chirurgie plastique, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: May
authors.affiliation: Service de Dermatologie, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Schneider
authors.affiliation: Service de Dermatologie, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: C
authors.initials: C
authors.lastname: Vilmer
authors.affiliation: Service de Dermatologie, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Bagot
authors.affiliation: Service d'Anatomie Pathologique, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Battistella
authors.affiliation: Service de Dermatologie, AP- HP Hôpital Saint Louis, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Petit
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage; D000328:Adult; D000634:Aminoquinolines / Q000008:administration & dosage*; D001706:Biopsy; D003078:Colchicine / Q000008:administration & dosage*; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D004333:Drug Administration Routes; D005260:Female; D005500:Follow-Up Studies; D005533:Foot Dermatoses / Q000175:diagnosis* / Q000628:therapy; D061826:Foot Orthoses; D005938:Glucocorticoids / Q000008:administration & dosage; D006074:Gout Suppressants / Q000008:administration & dosage; D006801:Humans; D000077271:Imiquimod; D007627:Keloid / Q000175:diagnosis* / Q000628:therapy; D007641:Keratolytic Agents / Q000008:administration & dosage; D008279:Magnetic Resonance Imaging; D008297:Male; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome; D014221:Triamcinolone / Q000008:administration & dosage*
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D005938:Glucocorticoids; D006074:Gout Suppressants; D007641:Keratolytic Agents; D014221:Triamcinolone; D000077271:Imiquimod; D003078:Colchicine