title: Advancing Keloid Treatment: A Novel Multimodal Approach to Ear Keloids.
abstract: OBJECTIVE
  Management of keloids of the pinna, in particular, those located in the helix and antihelix and lobule that occur as complications of ear piercing.
  
  
  METHODS
  Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT). Radiation protocol consisted of 1 to 3 fractions, with cumulative dosage ranging from 1,300 to 1,800 cGy. Average follow-up was 24 months to assess for evidence of recurrence and adverse side effects.
  
  
  RESULTS
  Fifty ear keloids were treated with this method, age from 15 to 66 (mean = 32, SD = 16) of which 14 were male and 35 female. Almost 30% (n = 14) of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who reported recurrence.
  
  
  CONCLUSIONS
  Surgical excision combined with intraoperative PRP, adjuvant postoperative in-office SRT achieved a 94% nonrecurrence rate on follow-up over a 2-year period. Outcomes provide preliminary, albeit, strong evidence to support this multimodal method as a viable alternative in the management of keloids localized to the ear.
authors.affiliation: *Lexington Plastic Surgeons, New York, New York; †Hunter-Bellevue School of Nursing, Hunter College, New York, New York.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Jones
authors.forename: Jennifer
authors.initials: J
authors.lastname: McLane
authors.forename: Rachael
authors.initials: R
authors.lastname: Adenegan
authors.forename: JoAnne
authors.initials: J
authors.lastname: Lee
authors.forename: Christine A
authors.initials: CA
authors.lastname: Ganzer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D046288:Body Piercing / Q000009:adverse effects*; D003131:Combined Modality Therapy; D054644:Ear Auricle / Q000473:pathology*; D006801:Humans; D007627:Keloid / Q000209:etiology / Q000532:radiotherapy* / Q000601:surgery*; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps; D055815:Young Adult