Keloid in Iraqi patients: a clinicohistopathologic study.

Background: Keloid is a benign, well-demarcated area of fibrous tissue overgrowth that extends beyond the original defect. It is not an uncommon problem and is encountered frequently in daily practice.

Objective: To evaluate the different clinical and histopathologic aspects of this disease in Iraqi people.

Methods: Eighty-eight patients with keloid were clinically assessed. Histopathologic examination was performed in 16 patients. Giemsa stain was used in eight patients to assess the presence of mast cells.

Results: There were 47 females and 41 males. The disease started in the second and third decades of life in 62 patients (70.5%). Itching was present in 46 patients (52.2%) and was more predominant in those with early lesions. Darier sign was elicited in 22 patients (25%); all of them had itching. The duration of the disease ranged from 0.33 to 20 years, with a mean of 5.4 years. Spontaneous keloid was found in 30 patients (34%). The lesions were mainly single (63.4%). All of these patients had lesions on the face and upper trunk in addition to involvement of extremities in five of them (16.7%). BCG keloid was observed in females only, and it showed downward gravitational extension in three of seven patients (43%). The histopathologic examination of keloid in 16 patients showed many interesting findings, such as the presence of hyperplastic epidermis in six specimens (37.5%), Grenz zone in 11 patients (68.75%), telangiectasia in 12 patients (75%), and pseudopodia extension of the growth to the adjacent tissues in half of the patients. Giemsa stain of eight specimens demonstrated the presence of mast cells in four patients (50%), more in biopsies that were taken from early lesions.