The sensation of pain can be the result of a lesion that is primarily tender, or because of rubbing of a pedunculated keloid against clothing or furniture. Keloids are often symptomatic causing itching, burning, and pain. The postoperative keloid recurrence is frequently worse than the initial lesion. After appropriate surgery is performed, a hypertrophic scar will often improve whereas a keloid (except perhaps on the earlobe) nearly always recurs unless adjunctive therapy is implemented. Keloids are most often found in areas in which there is limited or no motion, such as the chest and back. Hypertrophic scars are more likely to occur in areas prone to excessive motion, such as those across joints. Hypertrophic scars achieve a shape that is relative to the size and shape of the preceding trauma, whereas keloids exceed, sometimes greatly, the extent of the initial trauma. Ultimately hypertrophic scars will subside with time whereas keloids generally progress until such time as they become stable. Hypertrophic scars develop rapidly after surgery, whereas keloids may occur months after the inciting trauma. It is the early, pruritic, red keloid that can be a difficult diagnosis. A mature, aged keloid presents little clinical debate. This is not merely an academic issue because the lesions respond quite differently to therapy. Keloids rarely represent a clinical dilemma except in distinguishing them from hypertrophic scars ( Table 44.2). The clinical manifestations of keloids are discussed as they pertain to therapeutic options. Hilary Baldwin MD, in Surgery of the Skin, 2005 Clinical manifestations Mucin is deposited focally in the dermis, and hyaluronic expression is confined to the thickened, granular/spinous layer. Alpha smooth muscle actin is oriented around the vessel wall, and myofibroblasts are absent. Histologically, keloids are characterized by thick, large, closely packed bundles of disorganized collagen. Interestingly, keloids only occur in humans and no keloid animal model exists. Keloids do not commonly involve joints and contracture is rare ( Tuan and Nichter, 1998). The most common areas affected by keloids are the upper body sebaceous areas. These scars can cause pain, burning, and itching. Keloids can be particularly disfiguring due to their nodular appearance, size, and color, which tends to be dark and erythematous ( Shaffer et al., 2002, English and Shenefelt, 1999, Atiyeh et al., 2005, Niessen et al., 1999). These growths can be extremely irritating, but the clinical manifestations are highly variable between patients. Keloids form over a period of two to three months and almost never spontaneously regress. Keloid scars are also raised, erythematous and pruritic, but they extend far beyond the original wound margins ( Peacock et al., 1970). Lorenz, in Advanced Wound Repair Therapies, 2011 3.3.2 Keloids It's a good idea to let the thick sealed edge lie outside the glass sheets.Īnd last, Set aside the assembly to cool completely before removing the piece for inspection.B.J. The plastic bags will probably add to the time it takes to heat things up. If water damage is a concern, put the piece inside a sealed water-proof plastic bag before you sandwich it. I alternated heating sides several seconds at a time. I used the (very) hottest water that comes from my kitchen sink faucet. Run hot (70☌/145☏) water over both sides of the area to heat it up evenly. You can see the points of contact through the glass If you break the glass with the pressure of the clamps, maybe they were too strong. Sandwich the rumpled piece of vinyl between two sheets of "picture-frame" glassĬlamp the sandwich layers firmly together flat with spring paper clamps I don't know what "KEM" card plastic is made of either.Īlso, my "problem" was thinner than what I would imagine a plastic "KEM" card would be. My "problem" had no sharp folds, it was simply bent a bit "wavy." It (or a similar technique) might work as advertised for your plastic "KEM" card. I just used this technique to flatten bent vinyl.
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