Management of keloids in the United States, 1990-2009: an analysis of the National Ambulatory Medical Care Survey.

Abstract

BACKGROUND:

Keloids can cause significant morbidity during wound healing, but the most common current treatment practices for keloids are not well-established.

OBJECTIVE:

To determine the main treatments used for keloids in the United States and demographics of patient visits for keloids.

METHODS:

The National Ambulatory Medical Care Survey for 1990-2009 was queried for visits with a diagnosis of keloids. Leading medical and procedural treatments, patient demographic characteristics, physician specialties, reasons for visit, and comorbidities were assessed.

RESULTS:

There were an estimated 427,500 visits per year for keloids, with a slight decline in frequency of visits over time (p = .001). Triamcinolone was the leading medical treatment, and excision or destruction of a lesion was the leading procedural treatment. Sixty-two percent of patients were female, and 23.7% were African American. Mean age was 36.6. Dermatologists managed slightly more than half of visits, and plastic surgeons were second most used.

CONCLUSIONS:

Keloids are managed using a variety of treatments, primarily triamcinolone and excision or destruction of a lesion. High-quality evidence is lacking for the efficacy of most existing keloid treatments. New treatments that improve on the present standard of care would improve outcomes.

• Authors: Scott A Davis, Steven R Feldman, Amy J McMichael
• Journal: Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.] (Dermatol Surg) Vol. 39 Issue 7 Pg. 988-94 (Jul 2013) ISSN: 1524-4725 [Electronic] United States
• PMID: 23463963 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

Chemical References

• Glucocorticoids
• Triamcinolone

Topics

• Adult
• Comorbidity
• Female
• Glucocorticoids (therapeutic use)
• Health Care Surveys
• Humans
• Keloid (drug therapy, epidemiology, surgery, therapy)
• Male
• Practice Patterns, Physicians'
• Triamcinolone (therapeutic use)
• United States