Ibrahim Abdulrasheed, Abubakar M. Lawal, Maina J. Daniel, Adebayo O Wasiu, Asuku E Malachy
Study Background: The management of earlobe keloids following multiple earring piercings poses a difficult and intriguing challenge to the patient and surgeon. It is a disfigurement with noteworthy physical and psychological burden for the female adolescent population which is worried about their appearance. Patients and method: We retrospectively reviewed all patients with earlobe keloids treated using a protocol of surgical excision and intralesional triamcinolone injection, between 2008 and 2013. A standard form was used to collect and record data from patient files including; age, duration of keloids, age at first earring piercing, number of earring piercing, age at subsequent earring piercing, and earring piercing that developed a keloid. Treatment outcome was recorded as recurrence or non-recurrence.
Results: One hundred and eight earlobe keloids in sixty patients were treated with our protocol. Forty two (70%) patients had two earring piercings on the earlobe. Age at first earring piercing on the ear lobe was before the age of one year in the majority of the patients. 58 (97%). The second and third earring piercing was associated with formation of keloids in 49 (82%) and 9(15%) patients respectively. Four patients had de-pigmentation of the earlobe, and one patient had a minor wound dehiscence while another had a mild postoperative wound infection. Recurrence occurred in 16 patients (27%). Recurrence was significantly associated with the number of earring piercing, age at first earring piercing, age at subsequent earring piercing, earring piercing that developed a keloid and family history of keloids.
Conclusion: A combination of intramarginal excision and post-operative intralesional injection of triamcinolone is effective for the management of earlobe keloids. The results of this study suggests that multiple ear ring piercings should be discouraged after the age of puberty or perhaps not at all in patients with a family history of keloids
