Should excised keloid scars be sent for routine histologic analysis?

Introduction: Keloid scarring is a clinical diagnosis, usually preceded by a history of localized trauma. Significant variation exists as to whether excised specimens are sent for routine histologic analysis. We aimed to review the histology of all clinically diagnosed keloids at our unit. Methods: All keloids diagnosed clinically and excised were identified between April 1995 and April 2006. The subsequent histology results were analyzed. Results: Five hundred sixty-eight specimens were sent for pathologic investigation over an 11-year period. Four hundred fifty-eight (81%) were reported as keloid, 60 (11%) as acne keloidatis, 3 5 (6%) as hypertropbic scar, and 14 (2%) as normal scar. There were no reported malignancies or dysplasias. Discussion: These histology results suggest that, given a good clinical suspicion of keloid, it may be unnecessary to send specimens at excision for routine histology.