Most appropriate management of Recurrent Keloid is?: (A) Excisional surgery, (B) Intramarginal excision followed by radiation, (C) Cryosurgery, (D) Silicone gel sheeting
Answer is B. Treatment: Keloids rarely regress with time, often refractory to medical and surgical intervention First line treatment: silicone in combination with pressure therapy and intralesional coicosteroid injection Refractory cases (after 12 months of therapy): excision + post op radiotherapy (external beam or brachytherapy) New treatment modalities: internal cryotherapy and 5% imiquimod