33 years old
female patient diagnosed with keloid located in chest area was treated. The
patient was referred to our clinic due to pain and aesthetic complaints.
Written and verbal informed consent was obtained from the patient. The
patient’s demographic details and family pedigree were recorded due to genetic
factors may plat role in disease. The case has had the keloid since 1998, only
a small acne on the chest that has become such a wide dimensions in 6 years
time. The case explained the acne became a wound after scratching frequently
and afterwards became a keloid. Our patient received crotherapy treatment for
four sessions with each of the sessions have three week intervals in 2004.
This
therapy repeated in 2006 also and had no gain in reduction of the size in
keloid. Steroid injection was given once every five weeks into the keloids and
a reduction height and volume in was observed but the colour became redder
after this treatment procedure. Because of this reason our patient did not want
to seek this treatment again even though the keloid was not healed. Before our
treatment began, our patient had been using another taping method named Haelan
Tape including an I band over keloid. This tape is a tight and firm tape
covering keloid and has an impermeable tissue
On
observational clinical examination, researchers measured keloid’s dimensions by
using a standard tape measure. The case has a keloid on the chest in the
localisation medio-lateral 7,4 cm and supero-inferior 5,1cm dimensions (Figure
1). The keloid was stiff; there was an increase in pain with palpation. The
colour of keloid varied between pink to red that causes an aesthetic problem
for our case. The intensity of pain felt during activity and rest was measured
by Visual Analogue scale (VAS). Pain intensity was marked on a 100-mm
horizontal line, in which 0 expresses no pain and 100 mm expresses maximum pain
the patient felt. Her pain was found out to be as high as 5/10 (where 0
indicates no pain and 10 is the worst pain imaginable). The pain was evident
especially when a pressure was implemented on to keloid area and did not change
with activity.
The patient
was decided to treat with Kinesio-taping method on the keloid area (Figure 2).
Before the application was performed, the case was questioned for any
allergenic reactions, then fully informed about all adversed invents including
itching, sting, any other types of sensations giving discomfort and also
erythema or increase in pain was set an exclution criteria for implemetation.
The keloid was covered with I band with % 50 tension, taping technique. Two
pieces of I bant were used, one vertically-upright, the other one was applied
in horizontal direction. After the taping was completed, the area was rubbed to
activate the kinesio-tape. Taping was renewed per 4 days, the tape was removed
1 hours before a new application was performed, to observe any allergic
reactions. The case seek treatment for 3 months. Pain and the size of scar
tissue was assesed before and after 3 months treatment.
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