Discussion in 'Spot Diagnosis' started by Egyptian Doctor, Dec 17, 2012.
What is your medical diagnosis ?
Keloid secondary to ear piercing.
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 ?
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
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 =/.
Answer : Keloid
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