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Keloid & Hypertrophic

Scar
Hasna Aulia J

Preseptor:
Almahitta Cintami Putri, dr., Sp.BP-RE(K)

PSPD Departemen Ilmu Bedah


Fakultas Kedokteran Universitas Padjadjaran
Rumah Sakit Dr. Hasan Sadikin Bandung
Permasalahan

1. Estetika
2. Fungsi
Scar

• The end result of wound healing is a scar


• The end result of normal scar:

Proliferative scar

collagen synthesis/deposition collagen lysis/degradation

• Mature scar, which has approximately 80% of the tensile strength of normal unwounded skin, occurs between 6 and
18 months after wounding
• Proliferative scar -> wound extend beyond reticular dermis
Definisi Proliferative Scar

Keloid Hyperthropic Scar


bekas luka yang
bekas luka yang berasal dari
terbentuk atas jaringan
jaringan kolagen tebal
kolagen yang tumbuh
namun tidak melewati batas
berlebih melewati batas
awal luka
awal luka
Definisi Proliferative Scar

Keloid Hyperthropic Scar


bekas luka yang
bekas luka yang berasal dari
terbentuk atas jaringan
jaringan kolagen tebal
kolagen yang tumbuh
namun tidak melewati batas
berlebih melewati batas
awal luka
awal luka
Histologi

Keloid Hyperthropic Scar


Features of
Whorls of young fibrous
hypertrophic scar with
tissue and fibroblasts
added feature of thick,
in haphazard arrangement
eosinophilic, acellular
bands of collagen.
Histologi

Keloid Hyperthropic Scar


Features of
Whorls of young fibrous
hypertrophic scar with
tissue and fibroblasts
added feature of thick,
in haphazard arrangement
eosinophilic, acellular
bands of collagen.
Karakteristik Proliferative Scar
Keloid Hyperthrophic Scar
• Raised
• Familial predisposition • Erythematous
• Enlarged heaped-up scar that • Pruritic
• Remain at the site or confines of the original
extends beyond the margins of the
original wound wound
• Rarely regress • Partial or total resolution or regression can
• Frequently result from relatively spontaneously occur
• Result from trauma, incision, burns
minor injury or insult
• Elevated TGF-beta • Result from prolonged wound healing
• Increased epidermal/dermal thickness
• Lack of epithelial ridges
• Random orientation of collagen fibrils
• Decreased collagen content
• Elevated TGF-beta
• Increased number of mast cells
• Decreased collagen production
Waktu Pembentukan
Hypertrophic Scar Keloid

Morfologi
Hypertrophic Scar Keloid
Riwayat keloid pada keluarga, terasa
gatal atau tidak, rasa nyeri pada
bagian yang menebal

Mekanisme terjadinya luka primer,


tindakan yang dilakukan dan operator
Diagnosis : yang melakukan penjahitan
Anamnesis

Pertambahan ukuran sejak awal


membesar sampai saat dilakukan
pemeriksaan
Treatment

+ Massage, silicone eksisi-> radiasi-> menuruni rekurensi


(multimodalitas)

Hypertrophic Scar Keloid


Sumber
• Kevin C. Chung – Grabb & Smith’s Plastic
Surgery
• Wolff, K, Goldsmith, L, Katz, S, Gilchrest,
B, Paller, AS & Leffell, D 2011, Fitzpatrick's
Dermatology in General Medicine, 8th
Edition. McGraw-Hill, New York.
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