Shopily 27 April 2023

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KELOIDS

Treatments

The best treatment is prevention in patients with a known predisposition. This includes preventing unnecessary trauma or surgery (including ear piercing, elective mole removal), whenever possible. Any skin problems in predisposed individuals (e.g., acne, infections) should be treated as early as possible to minimize areas of inflammation.

Treatment of a keloid scar is age dependent. Radiotherapy, anti-metabolites and corticoids would not be recommended to be used in children, in order to avoid harmful side effects, like growth abnormalities

In adults, corticosteriods combined with 5-FU and PDL in a triple therapy, enhance results and diminish side effects. Further prophylactic and therapeutic strategies include pressure therapy, silicone gel sheeting, intra-lesional triamcinolone acetonide (TAC), cryosurgery, radiation, laser therapy, INF,5-FU and surgical excision as well as a multitude of extracts and topical agents.

Surgical excision is currently still the most common treatment for a significant amount of keloid lesions. However, when used as the solitary forrn of treatment there is a large recurrence rate of between 70 and 100%. It has also been known to cause a larger lesion formation on re occurrence. While not always successful alone, surgical excision when combined with other therapies dramatically decreases the recurrence rate. Examples of these therapies include but are not limited to radiation therapy, pressure therapy and laser ablation. Pressure therapy following surgical excision has shown promising results, especially in keloids of the ear and earlobe. The mechanism of how exactly pressure therapy works is unknown at present but many patients with keloid scars and lesions have benefited from it.

Should keloids occur, the most effective treatment is superficial external beam radiotherapy (SRT), which can achieve cure rates of up to 90%.

Additionally, intralesional injection with a corticosteroid such as Kenalog does appear to aid in the reduction of inflammation and pruritus.

Cryotherapy or cryosurgery is an application of extreme cold to treat keloids. This treatment method is easy to perform and has shown results with least chance of recurrence

Epidemiology

Persons of any age can develop a keloid. Children under 10 are less likely to develop keloids, even from ear piercing.

WITH DR R. SINGH

This skin Feature was rendered by Dr Raj Singh, educating the community on skin disease. He is available for a consultation at his, Scottsville branch in Pietermaritzburg or at his Durban branch.

Keloids may also develop from Pseudofollicul itis barbae; continued shaving when one has razor bumps will cause irritation to the bumps, infection, and over time keloids will form. Persons with razor bumps are advised to stop shaving in order for the skin to repair itself before undertaking any form of hair removal. The tendency to form keloids is speculated to be hereditary. Keloids can tend to appear to grow over time without even piercing the skin, almost acting out a slow tumorous growth; the reason for this tendency is unknown

Cause

Most skin injury types can contribute to scarring. This includes bums, acne scars, chickenpox scars, ear piercing, scratches, surgical cuts or vaccination sites.

According to the (US) National Center for Biotechnology Information, keloid scarring is common in young people between the ages of 10 and 20. Studies have shown that those with darker complexions are at a higher risk of keloid scarring as a result of skin trauma. They occur in 15 - 20% of individuals with African, Asian or Latino ancestry, significantly less in those of a Caucasian background and there are no reported cases in patients with albinism. Keloids tend to have a genetic component, which means one is more likely to have keloids if one or both of their parents has them. However, no single gene has yet been identified which is a causing factor in keloid scarring but several susceptibility loci have been discovered, most notably in Chromosome 15.

Pathology Histologically, keloids are fibrotic tumors characterized by a collection of atypical fibroblasts with excessive deposition of extracellular matrix components, especially collagen, fibronectin, elastin, and proteoglycans. Generally, they contain relatively acellular centers and thick, abundant collagen bundles that form nodules in the deep dermal portion of the lesion. Keloids present a therapeutic challenge that must be addressed, as these lesions can cause significant pain, pruritus (itching), and physical disfigurement. They may not improve in appearance over time and can limit mobility if located over a joint.

Keloids affect both sexes equally, although the incidence in young female patients has been reported to be higher than in young males, probably reflecting the greater frequency of earlobe piercing among women. The frequency of occurrence is 15 times higher in highly pigmented people. African descendant people have increased risk of keloid occurrences Micrograph of keloid. Thick, hyalinised collagen fibres are characteristic of this aberrant healing process. H&E stain

DR R. SINGH SPECIALIST DERMATOLOGIST

DR R Singh is a specialist dermatologist with offices in Pietermaritzburg and Durban and offers the following:

• General Dermatology/

• Diagnosis Plus Mole Mapping for Skin Cancer’s

• Dermatological Surgery

• Photo Dynamic Skin Therapy for Cancers

• Non Surgical Face Lift

• Laser Liposuction

• Platlet Rich Therapy

• Fat Transfer

• e Matrix

We stock Heliocare and Neostrata products and we deliver nationwide. Click here for more info

We stock skin care products formulated by DR R Singh for all skin types and skin conditions

Contracted to most Medical Aids. T’s and C’s apply

Are you ready to experience an adrenaline-fueled psychological thriller that will leave you on the edge of your seat? This July, filmmaker and director Arish Sirkissoon, in collaboration with producers Dr. Raj Singh and Edwin Cole, brings you ...

"You're Next,"

a riveting cat-and-mouse feature film that will keep audiences captivated and craving more. The story follows Detective Khumalo (Sibonelo Cele), who finds himself entangled in a complex case when a bloodied girl shows up at his station with an elaborate story. In desperation, he contacts an old friend and specialist, Detective Khan (Dr.Raj Singh), to help him come to terms with the information. Their investigation takes them down a path of murder and deceit linked to the social media world.

The cast includes Drew Baillie as Sandra, Rahul Polton as Clint, Tamlyn Prosser as Delilah, Dylan Swanepoel as Adam, Rakshana Singh as Detective Singh, and Arish Sirkissoon as Xavier Knight.

The film's tagline, "Everyone is dying to be liked," speaks to its underlying theme of the dangers of social media and the lengths people will go to for attention. Also includes Ashnee Singh, Anita Kadir from Pietermaritzburg So, are you ready to be thrilled, captivated, and left craving more? "You're Next" promises to deliver an unforgettable experience that will leave you questioning who your friends really are. Don't miss it in theatre's this July.

ALMOND CRESCENTS

INGREDIENTS

* 250 grams butter

* 1 cup icing sugar

* 1/2 cup oil

* 1 /2 cup nib bed almonds

* 1 /2 cup Maizena

* 2 and 1 /2 cups flour

* Icing sugar for dusting

METHOD

Cream butter till light. Add sugar and cream well. Add oil and cream.

Add Maizena and nibbed almonds and mix well. Add flour and mix well. Make into crescent shapes and bake at 180 degrees for 10 minutes. When cool sprinkle icing sugar.

Spreading the Light of the Vedas

Dr Roshan Singh

Aries

Today’s transits are strong for connecting with information or helpful people to improve your finances, dear Aries. You’re learning about your values and how much you can depend on and provide for yourself. It’s an excellent time to review how you’re managing your resources, including your talents, things, and money.

Taurus

With Mercury retrograde in your sign, some introspection can be beneficial now, dear Taurus. However, watch for overthinking today–you’re inclined to separate from your affections and feelings when making a decision, which is valid only in certain situations.

Gemini

You are more inclined to examine the past for answers these days, dear Gemini, but while the tendency is to do so analytically, you may benefit a lot more if you engage your feelings. You’re learning to let go of unnecessary worry and guilt or to put your faith in a larger plan.

Cancer

There is some tendency to overthink things early today, dear Cancer, particularly related to your social life, networks, and friendships. Try not to let this go too far. Later today, the Moon moves into your sign, and you want to feel alive and connected to the world around you. It’s easier to spread your wings. You may want to reach out and connect.

Leo

Watch for the tendency to overthink your long-term plans today, dear Leo, and possibly to fret over things that are not under your control. Don’t let this overpower your gut feelings or overshadow your emotional needs. Fortunately, you seem to gravitate to people, situations, or information that encourages you to grow, rise to a challenge, and elevate your goals.

Virgo

You’re in good shape for learning, writing, studying, and making connections, dear Virgo. Today’s energies are particularly useful for reaching out or pouring more of yourself into projects you enjoy. It’s an excellent time to honor uniqueness and freedom of spirit. There can be some mixed signals today since it’s not always easy to read others’ needs and wants.

Libra

You are especially sensitive to others’ moods today, and your equilibrium can be upset rather quickly, dear Libra. On the other side, watch for overthinking to the point that you ignore what you feel about a matter today–it’s not an ideal time for hard and fast decision-making. It’s time to approach things differently, but this doesn’t have to happen all at once.

Scorpio

Relationships are again in strong focus today, dear Scorpio, and it’s a favorable period for progressing and moving forward. Certainly, with Mercury retrograde in your partnership sector, you might often look back or return to past conversations in the relationship department. However, experiences now can also alert you to the need to learn, grow, and improve.

Sagittarius

You could gain some fascinating intel about someone’s motives or desires today, dear Sagittarius, even if they are doing their best to keep these things to themselves. But you could feel divided, with a part of you seeking light and easy interactions and another looking for a more profound connection or deeper meaning.

Capricorn

Watch for overthinking creative and romantic matters today, dear Capricorn. While you do need to review and backtrack in these areas, it’s not as urgent as you think! Although Mercury is retrograde and you are experiencing some reserve, a SunNode transit encourages you to take creative risks and express yourself more spontaneously.

Aquarius

While you could feel somewhat divided between work and play today, dear Aquarius, you’re in fine shape for discovering a balance. You have an open mind and an open heart right now so that new information can expand your perspective. There is more faith in your emotional life and ability to grow.

Pisces

Even with Mercury retrograde, mental energy and enthusiasm run high today, dear Pisces. Improving and refining your communications, projects, and knowledge is fun and rewarding. Your popularity can soar around your ideas, skills, expertise, or how you communicate and connect.

For an in depth Astrological report, owner and founder of Astroworld, Dr Roshan Singh can be contacted on Cell: 071 630 0834 | E-mail: punditroshan@gmail.com

For a full and detailed horoscope for 2023, email punditroshan@telkomsa.net

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