Dermoscopic Features of Keloid versus Hypertrophic Scar

Abstract

Keloids and hypertrophic scars are benign, localized proliferations of the connective tissue of the skin that represent a form of abnormal wound healing. Excessive scars may follow a deep injury of the dermis, like in burns, surgery, abrasion, piercings, vaccinations, and lacerations. Hypertrophic scars are raised, but they stay within the boundaries of the original wound, and there is a possibility of spontaneous regression. On the other hand, keloids are raised scars which spread beyond the original wound boundaries invading the skin surroundings. They may continue to grow over time and often recur following excision. Hypertrophic scars are usually more responsive to different treatment modalities than keloids. Dermatoscope is a helpful diagnostic tool that allows the in vivo evaluation of colors and microstructures of the epidermis, the dermo-epidermal junction, and the papillary dermis which are not visible to the naked eye. Its idea depends on trans-illumination of a lesion and studying it with a high magnification. Old dermatoscopes requires application of certain oil over the lesion to be examined while new dermatoscopes are provided with polarized light, rendering the fluid placed on the lesion unnecessary and hence allowing for a better inspection of the vascular morphology of the skin lesions through avoiding the excessive application of pressure on the skin surface. Dermatoscopes are classified into, dermat