Keloid in a Patient with Albinism

Keloid in a Patient with Albinism

Michael H. Tirgan, MD

SUMMARY of Patient with Albinism

Keloids are limited to humans and although the exact prevalence is unknown, they have been reported in 5%- 16% of Africans. Individuals with darker pigmentation are more susceptible to keloid formation, especially Africans and Asians. According to the literature, Caucasians are least effected and there has been only a few reports of albino patients with keloids. fte author identified a patient with albinism who presented with a keloid to his right ear after trauma at the Dr George Mukhari Academic Hospital in Garankuwa, South Africa. fte keloid was resected and sent for pathological evaluation to determine differences in collagen formation. fte specimen was compared with tissue from a similar African patient with a keloid due to trauma on the left ear. Both keloids were noticed six months after the sustained trauma.

INTRODUCTION

Keloids are collagenous lesions that extend beyond the original area of injury and are the result of abnormal wound healing.1 fte etiology of keloid formation is unknown,2 but it is believed to be from aberrant wound healing caused by excessive fibroblast participation and collagen deposition.3 fte highest incidence of keloids has been reported to occur between the first and third decade of life4 and the African population is most affected, with an incidence of 6%-16%.3 Many articles report that patients with albinism are spared from developing keloids3,5-9 and plastic surgery text books generally assert that keloids in patients with albinism have not been reported. Only one epidemiologic publication10 has reported a keloid prevalence rate of 7.8% in people with albinism in Kenya and Tanzania. To my knowledge, there is only one reported case of keloidalis nuchae in a patient with albinism who is from Mali.11
Here we report the first case of an earlobe keloid in a patient with albinism and discuss routine histologic findings compared with an earlobe keloid from an African non-albino patient.
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Legends

Figure 1: Earlobe keloid on patient with oculo-cutaneous albinism type 3.

albinism

albinism

Figure 2: H&E staining of keloid from albino patient (A) and African patient (B). Magnification 4x.

Thin epidermis Keloid starting mid-dermis
Thin epidermis Keloid starting mid-dermis

Normal epidermis Keloid starting lower in dermis
Normal epidermis Keloid starting lower in dermis

Figure 3: Masson’s trichrome stains positive for collagen in albino patient (A) and African patient (B). Magnification 4x.

Keloid in a Patient

Keloid in a Patient

Figure 4: Picrosirius stain for albino patient (A) stains positive for type I (yellow-orange) and III (green) collagen, with collagen type I being more prominent. The non-albino African control patient (B) also stains positive for type I and III collagen, with somewhat lesser type III collagen. Magnification 40x.

Patient with Albinism

Patient with Albinism