Histo-Morphological Patterns of Keloid Presentations

Abstract

Background/Objectives: Keloid is a healed human skin wound which extends beyond the confines of the original wound and is characterized by exuberant collagen deposition. This study investigated the unique features and contents of Keloid growth among patients attending specialist clinics in two teaching hospitals in Edo State. Materials and Methods: A five-year prospective institution-based analytical design was adopted which utilized structured questionnaires administered to volunteers, as well as tissue biopsies of the keloid masses. Fifty-five (55) patients of both sexes were pooled from both hospitals. Information on demographic and clinical patterns was obtained from the questionnaires, while those on tissue biopsies from the keloid masses were obtained by surgical excision under local anesthesia. The samples were processed in the laboratory using routine and special staining techniques and were examined microscopically and photomicrographed. Results and Conclusion: Analysis of the keloid biopsies of participants revealed connective tissue fibers, which were confirmed to be collagen fibers arranged in haphazard or nodular, haphazard and nodular as well as criss-cross patterns. The lesions which are mostly located on the head and neck region majorly affected darkly pigmented young adult females. The morphological patterns showed that there is heightened pigmentation of the basal layer of the epidermis in the keloid mass. The bulk of the Keloid masses is composed of collagen fibres produced by fibroblasts activated by cytokines which are released by intra lesional cellular infiltrates. Our findings in this study revealed that the keloids mostly appear hyper-pigmented. The thick band of collagen which constitutes the bulk of the keloid tissue is mostly disposed in haphazard pattern and produced by fibroblasts. The borders of the collagen bands are ill-defined, confirming the histological diagnosis of keloid