Isnt a Keloid supposed to be a scar,, how would you explain the smooth skin surface, and the marked redness seen in this photo... [/SIZE]
Good u raised this doubt, thanks (-: First let me answer whether this could qualify as a keloid ? Well, if i biposy it and see - type 3 collagen with exuberant granulation tissue, i will not shy away from calling it a keloid. Now can it look like the way it does in this image ? Yes, this is a very small trauma and the scar tissue will just end up growing into the surrounding skin and can look like this. Is there another possibility / differential diagnosis ? yes suppose the biopsy report said - cornified epithelium containing lamellated keratin, then i would call it an epidermoid cyst ( aka epidermal cyst, epidermal inclusion cyst, infundibular cyst and keratin cyst ). The mechanism in this case is migration of epidermis into dermis. this is a confirmed epidermal inclusion cyst, again from ear piercing. So was I smart in identifying the image in this challenge as keloid ? Absolutely NOT !!! Thanks again, becos if it was not 4 ur doubt, i wouldn't have given it a thought. So first differential - keloid ( no particular reason 4 putting it as the first differential ) Second differential - epidermal inclusion cyst (Y)
in fact that is the classic picture of a keloid. it's not like you could even doubt it, a trauam from earing perforation can easily do that. Xerxles was kind of rough =/.
