#9-2. Case series of Scar Treatment

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White mature old scar

Any experienced doctor would know how difficult it is to treat this kind of scar. The lesion was very small, but the white color made it more conspicuous and it felt hard to the touch. No matter how well conducted a surgery may be, this kind of lesion seldom ends well and is also not responsive to laser ablation.

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Treatment Procedure

1. Repetitive pulsed dye laser

2. Silicone gel application

This case ended well unexpectedly by repetitive pulsed dye laser. The effect might not have been that good if the lesion was located on the limbs or harder and broader.

Before treatment After treatment

Fig. 3. White mature old scar

Acne Keloidalis on the Trunk

- Acne keloidalis on the truck accompanies a greater number of lesions, compared to typical keloid.

- The lesion often cause itch or pain.

- Although steroid injection for typical keloid may improve the lesion, steroid itself is another cause of acne, creating a vicious cycle of developing acne keloidalis again.

Treatment Procedure

1. Oral isotretinoin

2. Oral tranilast(mast cell stabilizer)

3. Repetitive cryotherapy

4. Silicone gel application

It seems most imperative to stop the development of acne and pruritus by using oral agents in this type of patients. Steroid injection was avoided, if possible, and cryotherapy was selected to treat a large number of lesions within a short period of time. Cryotherapy does not induce systemic side effects and provides rapid therapeutic effect, but the intensity of the therapy should be adjusted properly to prevent color change, as shown in this case.