Hi All

I have a Chinese lady patient (mid 40s) with history of extensive keloid
formation following fairly trivial trauma to her arm and shoulder as a child
(smallpox vaccination and scratch from a pet monkey).

I have never treated anyone with this history before, she has painful
involuted hallux nails and would benefit from nail procedure.

Medline search produced a couple of case reports of keloid following
desyndactylism but is otherwise scant with information specific to foot.  As
I understand that keloids are most common in the upper limbs and sternal
area and pretty rare in the lower limb.

I am considering doing a partial nail avulsion with phenolisation of matrix
but find it difficult to asses and inform about risk for keloid reaction for
this procedure.

Does anyone have any experience or knowledge in this area?

I am wondering if antibiotic/steroid topical wound care during healing would
be indicated.

Thoughts appreciated


Cheers



Martin


Winnipeg Canada.




%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%