While a keloid and a hypertrophic scar may show look similar, clinical features can help distinguish between the two processes.
Parameter |
Keloidal Scar |
Hypertrophic Scar |
usual locations |
earlobes, shoulders, presternal skin, upper back |
abdomen |
occurrence at joints |
rare |
common |
unusual sites |
eyelids, genitalia, palms, soles |
|
relationship to motion and skin tension |
independent |
correlate with (occur in lesions crossing skin creases at right angles) |
boundary |
overgrows wound boundaries |
limited extent |
onset after inciting trauma |
may be delayed for weeks or months |
often develops shortly after injury |
onset without inciting injury (spontaneous) |
may occur |
rare |
size relative to inciting injury |
lesion out of proportion to injury |
size commensurate with injury |
regression over time |
rare |
usual |
outcome after surgery |
often worsened |
usually improved with appropriate surgery |
Other distinguishing features:
(1) history of previous keloids
(2) appearance with MRI (Babu et al)
Specialty: Dermatology