TREATMENT OF EARLOBE KELOIDS WITH SURGERY PLUS ADJUVANT INTRALESIONALVERAPAMIL AND PRESSURE EARRINGS

Treatment for keloids remains less than ideal. Previous discouraging r esults prompted a change in the author's standard treatment for keloid s to surgery plus adjuvant intralesional verapamil and pressure earrin gs. Intralesional verapamil (2.5 mg per milliliter) was administered 7 to 14 days after keloid removal and again approximately 1 month after removal when possible, Between 0.5 ml and 2.0 ml was administered eac h time, depending on the size of the keloid. Patients were instructed to wear pressure earrings essentially continuously for a minimum of 6 months after excision. Thirty-five African American patients with 45 e arlobe keloids were treated with this regimen. Information regarding r ecurrence was obtained by follow-up, mail, or phone call from 31 patie nts (89%) with 40 keloids (89%). Minimum follow-up for inclusion was 6 months and average follow-up was 28 months. Twenty-two keloids (55%) in 16 patients (52%) were cured by this treatment modality. There were no significant differences in recurrence rates related to sex, age, k eloid size, length of time the keloid was present, how long the ears h ad been pierced, and how many verapamil injections were received. Ther e was a trend toward an increased recurrence rate for previously treat ed keloids. Though not optimal, this regimen is superior to some previ ously evaluated regimens.