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--- med:keloid [2016/08/13 04:09] – V_L
+++ med:keloid [2024/07/04 03:42] (현재) – V_L
@@ 줄 13: / 줄 13: @@
 울통불퉁하고 검붉은 색을 띄며 표면은 미끈하고, 가렵거나 아플 수도 있다. 일단 생긴 켈로이드 흉터를 완전히 제거하기는 불가능한다. 수술적으로 해결될 수 있는 경우는 흔치 않으며, 대개는 흉터 부위에 스테로이드 주사를 주입함으로써 튀어나고 가렵고 아픈 증상을 줄여줄 수는 있다. 어느 정도의 기간동안 계속 흉터가 커지다가 멈추는 경향이 있다.
+{{:med:keloid_1442.png}}
 민간요법으로 식초나 빙초산을 피부병의 치료 목적으로 사용하다가 심한 화상으로 킬로이드 흉터를 만드는 경우가 종종 있다. 심지어는 [[misuse_acetate7|문신을 지우려다가]]   [[misuse_acetate72|더 뚜렷한 흉터만]]남기는 경우도 있다.
@@ 줄 21: / 줄 25: @@
 =====치료=====
-  * corticosteroid injections to reduce inflammation
+  * [[med:Intralesional steroid|corticosteroid injections]] to reduce inflammation
   * moisturizing oils to keep the tissue soft
   * using pressure or silicone gel pads after injury
@@ 줄 27: / 줄 31: @@
   * laser treatments to reduce scar tissue
   * radiation to shrink keloids
-====
-treat a dermal inflammatory process directly.
-http://www.dermnetnz.org/treatments/intralesional-steroids.html
-bypass the barrier of a thickened stratum corneum
-reduce the chance of epidermal atrophy (surface skin thinning)
-deliver higher concentrations to the site of the pathology.
-Administration of intralesional steroid
-Intralesional triamcinolone is injected directly into the skin lesion using a fine needle after cleaning the site of injection with alcohol or antiseptic solution. The injection should be intradermal, not subcutaneous, to avoid causing a dent in the skin.
-The initial dose per injection site will vary depending on the lesion being treated. Generally, 0.1–0.2 mL is injected per square centimetre of involved skin. The total dose should not normally exceed 1 or 2 mL per dose. It can be repeated every 4 to 8 weeks.
-The corticosteroid can be full strength (eg triamcinolone 10 mg/mL or 40 mg/mL) or diluted with normal saline or local anaesthetic. Typical regimes for triamcinolone intralesional injections include:
-mg/mL for a thick keloid scar
-mg/mL for a moderate thickness hypertrophic scar
-mg/ml into discoid lupus erythematosus or granuloma annulare
-mg/ml into skin of normal thickness associated with alopecia areata.
-The injections may be repeated monthly for a few months while the lesions are active..
-Early effects tend to be self-limited. They include:
-Pain, bleeding, bruising
-Infection
-Contact allergic dermatitis due to the preservative, benzyl alcohol
-Impaired wound healing
-Sterile abscess, sometimes requiring surgical drainage
-Delayed adverse effects include:
-Cutaneous and subcutaneous lipoatrophy (most common) appearing as skin indentations or dimples around the injection sites a few weeks after treatment; these may be permanent.
-White marks (leukoderma) or brown marks (postinflammatory pigmentation) at the site of injection or spreading from the site of injection – these may resolve or persist long term.
-Telangiectasia, or small dilated blood vessels at the site of injection. These can be treated if necessary by laser or intense pulsed light (IPL).
-Increased hair growth at the site of injection (localised hypertrichosis) – this resolves eventually.
-Localised or distant steroid acne: steroids increase growth hormone, leading to increased sebum (oil) production by the sebaceous glands. Steroid acne generally improves once the steroid has been stopped.
-[[misuse]]
-[[skin]]