Analysis of Surgical Treatments for Earlobe Keloids: Analysis of 174 Lesions in 145 Patients

Background: Treatments for earlobe keloids include surgical excision, postoperative radiotherapy, steroid injection, taping stabilization, and pressure therapy. However, to date, there is no universally accepted treatment strategy for earlobe keloid therapy. Methods: A total of 174 lesions in 145 patients who attended the keloid/scar specialist clinic at the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, between 2006 and 2011 were included and were classified as having primary keloids or recurring keloids. Mild scars, such as hypertrophic scars, were excluded from this study. Appropriate surgical approaches, postoperative adjuvant therapies, such as radiotherapy, and postsurgical self-management were applied. The postsurgical radiotherapy modalities were 15 Gy administered in three fractions over 3 days and 10 Gy administered in two fractions over 2 days. Recurrence during the following 18-month follow-up period was recorded. Results: Of the 174 lesions, 85.6 percent were primary keloids and 14.4 percent were recurrent keloids. Their recurrence rates were 4.7 percent and 0 percent, respectively. The overall recurrence rate was 4.0 percent. Complications during the 18-month follow-up period were not observed. The groups treated with 15-Gy and 10-Gy postsurgical radiotherapy did not differ significantly in terms of recurrence rate (p > 0.05). Conclusions: Earlobe keloids can be treated by customized plans that involve appropriate surgical modalities, postoperative radiotherapy, and self-management. Postsurgical radiotherapy with 10 Gy of radiotherapy administered in two fractions over 2 days can be used successfully to treat earlobe keloids. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.