This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: General surgery, Subject name: Surgery
True statement regarding keloid includes all of the following except - 
Select and explain. 
A. Recurrence is common, B. Affects surrounding areas as well, C. Intralesional steroid decreases chances of recurrence, D. Malignant changes present
D: Malignant changes present
Answer: D: Malignant changes present 
Explanation: A keloid scar is defined as excessive scar tissue that extends beyond the boundaries of the original incision or wound. Its aetiology is unknown but associated with elevated levels of growth factors, deeply pigmented skin, an inherited tendency and ceain areas of the body. The histology shows excess collagen (type III collagen) with hypervascularity. Keloid scars improve by application of pressure. They can also be managed by silicone gel sheeting, intralesional injections of steroids like triamcinolone, excision alone or followed by steroid injection or postoperative radiation. But if excision alone is done, it is associated with high chances of recurrences. Reference: Bailey & Love&;s Sho Practice of Surgery 27th Edition, Page No. 31