What is the difference between hypertrophic scars (HTS) and keloids?
A. Keloids are an overabundance of fibroplasia as a result of healing, hypertrophic scars are a failure of collagen remodelingHypertrophic scars (HTS) and keloids represent an overabundance of fibroplasia in the dermal healing process. HTS rise above the skin level but stay within the confines of the original wound and often regress over time. Keloids rise above the skin level as well, but extend beyond the border of the original wound and rarely regress spontaneously (Fig. below). Both HTS and keloids occur after trauma to the skin, and may be tender, pruritic, and cause a burning sensation. Keloids are 15 times more common in darker-pigmented ethnicities, with individuals of African, Spanish, and Asian ethnicities being especially susceptible. Men and women are equally affected. Genetically, the predilection to keloid formation appears to be autosomal dominant with incomplete penetration and variable expression.
Recurrent keloid on the neck of a 17-year-old patient that had been revised several times.