Head and neck keloid: treatment by core excision and delayed intralesional injection of steroid.

PURPOSE: This report aims to describe a technique used by the author for the management of head and neck keloid. PATIENTS AND METHODS: This is a clinical review of patients presenting with new and recurrent keloid of the head and neck to the Maxillofacial Surgery Unit at the Komfo Anokye Teaching Hospital, Kumasi, Ghana. The surgical technique involved the intralesional excision of the bulk of the keloid. Primary closure of the ensuring defect was achieved at operation. At the time of suture removal between 10 and 14 days postoperative, 40 mg triamcinolone was injected into the residual lesion. The injection was repeated on 2 more occasions at monthly intervals. All patients were followed up for at least 2 years. RESULTS: Eighteen patients were successfully treated with no sign of recurrence in any of them. The main complication was hypo-pigmentation at the site of the original lesion. CONCLUSION: The technique was found to be effective for the treatment of moderately sized new and recurrent keloid scars of the head and neck and is therefore recommended.