INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2752
www.rsisinternational.org
Radiotherapy Treatment for Keloid Patients: A Retrospective Case
Study in Sub-Saharan Africa
Emmanuel T. Andero
1*
, Anthonia Sowunmi
1
, Orimisan Belie
2
, Adebayo Abe
3
, Oluwadarasimi Ojediran
3
1
Department of Clinical & Radiation Oncology, Mbbs Fwacs Medserve-Luth Cancer Center. Lagos.
2
Department of Plastic and Reconstructive Surgery, Mbbs Fwacs., Lagos University Teaching Hospital
3
Department of Medical Physics, BSc MSc PhD., Medserve-Luth Cancer Center.
*Corresponding Author
DOI: https://dx.doi.org/10.51244/IJRSI.2025.1215PH000209
Received: 26 November 2025; Accepted: 02 December 2025; Published: 10 December 2025
ABSTRACT
Background: Keloid is an abnormal proliferation of scar tissue that extends beyond the boundaries of the original
wound, commonly seen in individuals with darker skin. Hence this study seeks to investigate the radiotherapy
treatment for keloid patients in sub-Saharan Africa.
Methodology: This retrospective study utilized data from both physical and electronic medical records at the
NSIA-LUTH Cancer Centre, covering the period from May 2019 to January 2025. A total of 100 patients
diagnosed with keloids during this time were reviewed. 73 keloid patients identified during the study period
received radiotherapy (RT). Descriptive and inferential statistics, including Pearson correlation and Chi-square
tests, were performed using SPSS version 27.0.
Results: Seventy-three patients with a mean age of 36.21 ± 13.72 years (range 15 - 84) were enrolled. More than
half of the population 37 (50.7%) were female and 36 (49.3%) were male. Body mass index (BMI) showed that
15 (20.5%) were healthy weight, 13 (17.8%) each were overweight and obese. 14 (19.2%) reported a family
history of keloids, and comorbidities were present in 6 (8.2%). Multiple site affectation were the commonest sites
in 17 (23.3%) of cases and ear lobes accounting for 12 (16.4%). Recurrence was reported in 30 (41.1%) of
patients. The most common causes of keloids in this population were injury and wound 11 (15.1%). The time
elapsed between the onset of lesions and diagnosis was 10 years and above for most patients 20 (27.4%). 34
(46.6%) of patients had surgical excision. All patients were treated with electron beam therapy. Different RT dose
regimens were applied in this study, including 12/4Gy 18 (25%), 12/3Gy 12 (16%), 9/3Gy 11 (15%), and 16/4Gy
9 (12%). There was a strong statistical significance between keloid recurrence and surgery (r = 0.544, p < 0.001).
Conclusion: This study highlights high incidence of keloids among young adults, especially females and rate of
recurrence. This study dose regimens aligns with international best practices. There is a need for early detection
of high-risk patients, combined therapy regimens, and tailored follow-up protocols to reduce recurrence.
Keywords: Keloid, Predisposing factors, Recurrence, Radiotherapy
INTRODUCTION
Keloids are an unwelcome and disfiguring consequence in the process of wound healing. They are
fibroproliferative lesions formed from scar tissue while healing skin wounds (1). These lesions occur after injuries
that penetrate the dermis, where fibroproliferation is integral to the healing process, unlike injuries that only affect
the epidermis (2). Keloids form as hard, often nodular growths. They are distinguished by a growth pattern that
extends beyond the original site of injury. This abnormal growth pattern is likely the result of an excessive
fibroproliferative response to injuries in individuals genetically predisposed to developing keloids. The initial
injury can be minor and often overlooked (2). However, keloids frequently arise from chronic inflammation caused
by ear piercings, recurring trauma from shaving, burn injuries, insect bites, cuts, and surgical incisions (2, 3).
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2753
www.rsisinternational.org
People of all races are affected by keloids even though some previous studies demonstrated that keloids
disproportionately occur in specific groups of patients. However, limited studies show that younger patients are
more prone to keloid formation (4). Evidence in India among 1000 patients showed that patients aged 10-30 years
are more affected (4) while another study reported among 120 patients in Nigeria found that young adults are
primarily affected (4). Various studies on keloid prevalence vary according to different countries, with estimates
of 0.09% in England (4), 8.5% in Kenya (4), 0.1% in Japan (4), and 16% in Zaire (4). However, Nigeria reported
an estimated incidence of 1.5 million in 2017 and about 36% of the figure accounted for by familial cases (5).
Evidence from 402 patients living in Ghana, Australia, Canada, and England found that the prevalence of keloids
was higher in the Ghanaian population. Another study reported a high rate of keloids in Chinese descent patients
among 175 patients of Malaysian, Indian, or Chinese descent. A UK-based heterogeneous cohort study examined
excessive scarring among 972 patients which reported prevalence rates of 1.1%, 2.4%, and 0.4% for Asian, Black,
and White patients, respectively (4).
Evidence has shown that surgical excision is the most common therapeutic method. However, there is still a high
recurrence rate of 50% within a year (6). Recently, postoperative adjuvant radiation therapy (RT) has been an
effective method in decreasing the rate of keloid recurrence, especially brachytherapy (6). A randomized trial
showed that patients undergoing surgery and adjuvant radiotherapy had less recurrence than patients undergoing
cryotherapy and intralesional steroid injection and even a better safety profile (7). Previous studies showed that
high-energy electron radiotherapy could provide a better dose distribution than kilovoltage X-rays for controlling
keloids (7). Studies have explored different radiotherapy modalities, doses, and fractionation schedules to optimize
outcomes. For example, electron beam radiation therapy (EBRT) using a dose of 10Gy fractioned for two days
can effectively treat keloid earlobes, and 20Gy fractioned over four days should treat the chest, scapular region,
and suprapubic region (8). Other studies reported a higher dose of 15Gy for earlobes keloids and cartilaginous
part of the auricle keloids with minimal recurrence rates (8).
Despite the effectiveness of radiation therapy for keloid treatment, there is still a paucity of robust data from sub-
Saharan Africa. Few single institutional studies have reported using low-dose RT protocols and recurrence rates
(2). This gap in the literature is particularly observable given the high prevalence of keloid-prone individuals in
this region, such as one conducted in Ibadan, which reported 14.5% recurrence rates among 175 cases with
postoperative RT (9). This five-year retrospective study aims to evaluate the pattern and clinical documentation
of keloid cases treated with radiation therapy in this region.
This study will contribute to the existing body of knowledge and also shape policy decision-making and evidence-
based practice on keloid management in the sub-Saharan context.
METHODOLOGY
The Nigeria Sovereign Investment Authority-Lagos University Teaching Hospital Cancer Center (NSIA-LUTH
Cancer Centre or NLCC) is a specialist cancer treatment facility, the seat of the medical and radiation oncology
department of the teaching hospital. The center provides modern systemic and advanced conformal radiation
therapy services in affiliation with in-hospital surgical services. NLCC is host to Nigeria's largest oncology
workforce in a single center, equipped with 3 Linear Accelerators, modern radiotherapy treatment planning
systems, and the only three-dimensional, high-dose-rate brachytherapy facility in the country, making it the
bestequipped radiation oncology center in the sub-region Africa outside of South Africa. The center’s 10
consultant oncologists all sub-specialized in different cancer sites lead a larger team of medical and radiation
physicists, radiation therapists, oncology nurses, and more. Surgical oncology has been established in the Lagos
University Teaching Hospital for decades with a recent ramping up of surgical oncology investment underway.
This retrospective study utilized data from both physical and electronic medical records at the NSIA-LUTH Cancer
Centre, covering the period from May 2019 to January 2025. A total of 100 patients diagnosed with keloids during
this time were reviewed. 73 keloid patients identified during the study period received radiotherapy (RT). The
diagnosis was based on clinical history and physical examination, while cases managed with surgical excision
were confirmed histologically. Data collected included patient age, gender, ethnicity, body mass index (BMI),
family history of keloids, comorbidities, site of affectation, recurrence, cause of keloid formation, disease duration,
surgical intervention, previous treatments received, and radiation therapy modalities.
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2754
www.rsisinternational.org
Descriptive statistics were used to summarize the demographic data, clinical features, medical history, and
treatment modalities of the patients. Inferential statistics were conducted to assess the relationships between family
history of keloids and clinical characteristics and medical history, as well as between keloid recurrence and these
same variables. The Chi-square test was applied at a 95% confidence level, with a p-value of <0.05 considered
statistically significant. All statistical analyses were performed using SPSS Statistics version 27.0.
RESULTS
Table 1 shows keloid patients’ socio-demographic characteristics. The mean age at presentation was 36.21 ±
13.72 years (range 15 - 84). Out of 73 patients, 23 (31.5%) were within 20 – 29 years, and 2 (2.7%) were above
70. More than half of the population 37 (50.7%) were female and 36 (49.3%) were male. The most common ethnic
groups were Yoruba 36 (49.3%) and Igbo 26 (35.6%), and the least common was Hausa 1 (1.4%).
Table 1 Socio-demographic Characteristics of Keloid Patients
Variables
Frequency
Percentage
Age range (years)
10 – 19
7
9.6
20 – 29
23
31.5
30 – 39
15
20.5
40 – 49
18
24.7
50 – 59
4
5.5
60 – 69
4
5.5
≥ 70
2
2.7
Mean ± SD of Age (36.21±13.72)
Table 2 demonstrates keloid patients’ predisposing factors for keloid development. 14 (19.2%) reported a family
history of keloids, and comorbidities were present in 6 (8.2%). A total of 18 sites (nose, ear lobe, ear, face, groin,
scapula region, scalp, occipital, jaw, chest, neck, chin, breast, hand, abdominal area, cheek, pre-auricular, and
pelvis) were affected, some patients 17 (23.3%) had multiple site affectation. Recurrence was reported in 30
(41.1%) of patients. The most common causes of keloids in this population were injury and wound 11 (15.1%),
and the least common 1 (1.4%) were surgery and furuncle. The time elapsed between the onset of lesions and
diagnosis was 10 years and above for most patients 20 (27.4%).
Table 2 Predisposing Factors for Keloid Development
Variables
Frequency (n)
Percentage (%)
Family History of Keloid
14
19.2
Comorbidities
6
8.2
Hypertension
6
8.2
Site of Affectation
Nose
1
1.4
Ear lobe
12
16.4
Ear
10
13.7
Face
5
6.8
Multiple body sites
17
23.3
Groin
1
1.4
Scapula region
1
1.4
Scalp
1
1.4
Occipital
1
1.4
Jaw
3
4.1
Chest
2
2.7
Neck
5
6.8
Chin
1
1.4
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2755
www.rsisinternational.org
Breast
1
1.4
Hand
1
1.4
Abdominal region
1
1.4
Cheek
2
2.7
Pre-auricular
1
1.4
Pelvis
1
1.4
Recurrence
30
41.1
Etiology
Injury & wound
11
15.1
Ear-piercing
8
11
Trauma
4
5.5
Surgery
1
1.4
Furuncle
1
1.4
Shaving
2
2.7
Disease Duration
0–5 years
13
17.8
6–9 years
3
4.1
≥10 years
20
27.4
Among the 37 (50.7%) of patients who underwent, 34 (46.6%) had an excision and 1 (1.4%) underwent incision
and drainage. Other treatments, include intralesional injections 14 (19%), cream 2 (2.7%), and cryotherapy 1
(1.4%). All patients in this population were treated with electron beam therapy (100%). The most frequently
utilized dose regimen was 12/4 Gy 18 (25%), followed by 12/3 Gy 12 (16%), 9/3 Gy 11 (15%), and 16/4 Gy 9
(12%).
Table 3 Treatment Modalities of Keloid Patients
Variables
Frequency
Percentage
Surgery
37
50.7
Excision
34
46.6
Incision and drainage
1
1.4
Radiotherapy
Electron Beam Therapy
73
100
Other Treatment
Intralesional Injections
14
19
Cryotherapy
1
1.4
Cream
2
2.7
Dose Regimen (Gy)
8/2
6
8.2
10 / 2
3
4.1
12 / 3
12
16
9 / 3
11
15
15 / 3
1
1.4
18 / 3
1
1.4
21 / 3
1
1.4
12 / 4
18
25
20 / 4
1
1.4
16 / 4
9
12
8 / 4
2
2.7
15 / 5
2
2.7
30 / 6
1
1.4
6 / 6
1
1.4
20 / 20
1
1.4
Mean ± SD (12.25±3.74)
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2756
www.rsisinternational.org
Table 4 examines the relationship between keloid recurrence and some predisposing factors and surgery. There
was a strong statistical significance between keloid recurrence and surgery (r = 0.544, p < 0.001). There was also
a positive significant (p<0.05) correlation between keloid recurrence and site of affectation, keloid history,
comorbidities, and etiology. Age and disease duration did not show a statistically significant relationship with
recurrence.
Table 4 Relationship between Keloid Recurrence and Some Variables of Keloid Patients
Variables
Pearson Correlation
Sig.
Recurrence – Age
0.142
0.231
Recurrence – Keloid History
0.374**
0.001
Recurrence – Comorbidities
0.354**
0.002
Recurrence – Site Affectation
0.300*
0.014
Recurrence – Etiology
0.382**
<0.001
Recurrence – Disease duration
0.223
0.058
Recurrence - Surgery
0.544**
<0.001
Table 5 evaluated the relationship between a family history of keloid and predisposing factors and surgery. There
was a strong significance between family history of keloid and comorbidities (r = 0.724, p < 0.001). There was
also a positive significant (p<0.05) correlation between family history of keloid and etiology, disease duration,
and surgery. Furthermore, there was no significant relationship between family history and age or site of
affectation.
Table 5 Relationship between Family History of Keloid and Some Variables of Keloid Patients
Variables
Pearson Correlation
Sig.
Family history of keloid – Age
0.004
0.976
Family history of keloid– Comorbidities
0.724**
<0.001
Family history of keloid– Site Affectation
0.056
0.654
Family history of keloid– Etiology
0.373**
0.001
Family history of keloid– Disease duration
0.407**
<0.001
Family history of keloid- Surgery
0.355**
0.002
DISCUSSION
All patients in this study treated with RT underwent Electron Beam Therapy (EBT) as the ionizing radiation for
postoperative keloid treatment, representing 100% of RT cases. This demonstrates a strong institutional preference
for EBT, often attributed to its capacity for accurately targeting skin lesions such as keloids while sparing
surrounding tissues (7). However, there is evidence that postoperative radiotherapy, particularly when
administered within the first 24 to 72 hours following excision, substantially reduces recurrence rates, (7, 13).
This was reported by Ketiku et al, where a new method of treatment of keloid was compared with an old technique
(13). This study is also consistent with Shen et al (7), who documented the application of hypofractionated EBT
for 568 keloid cases in China. Liu and Yuan (1) noted that all keloid patients treated between 2011 and 2017
received EBT. Different RT dose regimens were applied in this study, including 12/4Gy (25%), 12/3Gy (16%),
9/3Gy (15%), and 16/4Gy (12%). Abdus-salam et al (9) reported that 99.4% of keloid patients in Ibadan were
treated with 12/2Gy. Another Chinese study documented the use of 18/2Gy for hypofractionated electron-beam
therapy in keloid patients. The dose regimens in this study are consistent with the recommendations of Zainib and
Amin (3) (12 to 20 Gy and 3 to 4 fractions daily at 3 to 4 Gy per fraction) for keloid radiotherapy.
In this study, surgery in general accounted for 50.7%, surgical excision for 46.6%, and incision & drainage (1.4%)
cases in this population. These findings are consistent with standard clinical practice where excisional surgery
remains a first-line therapy for large or symptomatic keloids (3). However, it has been documented that surgical
excision alone has a high recurrence rate varying from 45 – 100%, especially without adjuvant treatment (9). The
correlation study also showed a moderately strong positive correlation between surgery and recurrence of keloid
(r = 0.544), indicating that patients who were managed with surgical excision were more likely to experience
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2757
www.rsisinternational.org
recurrence. The correlation was highly statistically significant (p < 0.001), which suggests that the relationship is
unlikely to have occurred by chance. This corroborates with current literature that has reported high recurrence
rates with surgery, frequently in excess of 45–70%, especially in the absence of adjuvant treatment like
radiotherapy (3, 4).
The patients in this study had an age range from 15 to 84 years, with an average age of 36.21±13.72 years and a
median age of 34. The most common (31.5%) age group of patients was between 20 – 29 years, followed by
24.7% within the 40 – 49 years range. Abdus-salam et al. (9) found 42.4% of the patients were in the 20- to 29year
age group in Ibadan, while Kouotou et al. (10) noted that 69.6% of the patients were more than 25 years of age in
Yaoundé, Cameroon. Research indicated that keloids are more commonly seen within 10 – 40 years of life (5),
observed in this study. Other studies have noted an increased prevalence of keloids in the age group reported here.
Olasode and Bello (14) reported that 35.1% of patients were between 20 and 29 years of age in South West Nigeria,
whereas, in the other study conducted in Calabar, 53.64% were of the same age group (15).
More than half (50.7%) of the study population were females and 49.3% accounted for males. Isamah et al(2)
found 54.1% of the patients were female in Southern Nigeria, while Kouotou et al (10) noted that 54.9% were
female in Cameroon. Previous literature has indicated that women are more prone to keloid development.
Women are also concerned about their beauty and are more often preoccupied with the negative esthetic impact
that keloid may cause. However, they are more prone to consult. On the contrary, Anaba et al (16) documented a
male preponderance, which accounted for 56% of their population. However, it was theorized that male
preponderance was probably due to the high prevalence of trauma as the cause of the keloid in their population.
Another study conducted in Ibadan (9) reported that 57% of the patients were male, while multiple lesions were
found to be more prevalent in women in Jamaican (4).
A family history was noted in 19.2% of patients, which included the father, mother, brother, sister, and grandmother
in this study. Isamah et al (2) reported that 25% of patients had a family of keloids in Southern Nigeria, while
another research indicated that 43% of patients had familial keloids (10). Persons with a family history of keloids
are four times more likely to develop keloids and eight times more prone to experience keloids at multiple sites,
highlighting a significant genetic underpinning factor in the occurrence of keloids (5). The formation of keloids
has been associated with genetics as the condition has been shown to run in families (5).
Among patients with a site of affectation documented, the most common sites were multiple body sites (23.3%),
the earlobe (16.4%), and the ear (13.7%). These findings indicate a relatively high burden of extensive or
multiregional keloid involvement, which may suggest a systemic or genetic predisposition among the affected
population (5). The predominance of the earlobe and ear as the frequent sites of keloid development align with
the findings of Isamah et al (2), who reported the earlobe as the most common site (35%) in their study. Similarly,
a study in Ibadan documented the ear as the most affected site in 35% of the patients (9), highlighting the
vulnerability of ear areas – often linked to damage from piercings or injuries (10). However, anatomical sites of
keloids vary significantly according to geography and population. Kouotou et al (10) identified presternum as the
commonest site (26.5%) in Cameroon. This is consistent with anterior chest involvement as the commonest site
in Ile-Ife, Nigeria (14), and chest involvement accounted for 25.5% of cases seen in a US-based study (4). These
findings suggest that the upper chest region is particularly prone to keloid formation and hypertrophic scarring
due to its elevated skin tension and intermittent traumatization (3,10).
This research recorded a marginally greater occurrence of females (50.7%) compared to males (49.3%). Isamah
et al (2) reported that females made up 54.1% of participants in Southern Nigeria, while Kouotou et al (10)
identified an even higher female prevalence of 54.9% in Cameroon. Additionally, Swenson et al (4) found that
65.9% of the population in the USA were females, whereas Anaba et al (16) noted a male dominance with 56% in
their Lagos study. Furthermore, Olasode and Bello (14) observed that females constituted 65% of the population
in South West Nigeria. The higher percentage of females may be attributed to their greater sensitivity towards
beauty or physical appearance, leading them to be more often focused on the potential negative aesthetic effects
that keloids can create (10).
The common causes of keloids in this study were Injury & wound (15.1%), ear piercing (11%), and trauma (5.5%).
These findings align with local and regional studies that identify skin trauma as a significant factor for keloid
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2758
www.rsisinternational.org
formation (11). Consistent with this, ear piercing was predominant in Southern Nigeria (32.4%) (10), highlighting
the cultural prevalence of ear decoration and auricular skin vulnerability to hypertrophic scarring. Furthermore,
Kouotou et al (10) indicated that wounds accounted for 38% of cases in Cameroon, which may explain the
relationship between wound healing and keloid pathogenesis among the Black Populations. Belie et al (17)
identified trauma (27%) and acne (20.1%) as the most common causes of keloid in their study. Evidence
demonstrated that poorly treated or manipulated acne can predispose to chronic inflammation and the formation
of excessive scar tissue, especially in adolescents with active sebaceous glands (18).
CONCLUSION
This study found high incidence of keloids in young adults, particularly females, and support was found for the
significant contribution of genetic predisposition and site-related determinants to disease expression and
recurrence. Notably, surgery remains the most common modality of management, but its strong association with
recurrence highlights the limitations of excision alone and suggests the value of adjunct therapies, in particular
radiotherapy. All patients in this study who had radiation therapy were given electron beam therapy, reflecting
institutional preference towards its precision in the management of superficial tumors. The heterogeneity of dose
regimens aligns with international best practices. The positive correlation of recurrence with comorbidities,
etiology of keloids, family history, BMI, and site of involvement suggests keloid recurrence is a multifactorial
process and should be treated with individualized and multidisciplinary management. In addition, the close
correlation between family history and several clinical parameters, including disease duration and comorbidities,
supports the impression that genetic and systemic influences are important in keloid behavior and treatment
response. There is a need for early detection of high-risk patients, combined therapy regimens, and tailored follow-
up protocols to reduce recurrence.
Statements and Declarations
This study is an original work and is the fruit of various researchers contributing in various capacities.
Funding
No funds, grants, or other financial support were received in the preparation of this manuscript.
Competing Interests
The authors have no relevant financial or non-financial interests to disclose.
REFERENCES
1. Liu CL, Yuan ZY. Retrospective study of immediate postoperative electron radiotherapy for
therapyresistant earlobe keloids. Arch Dermatol Res [Internet]. 2019 Aug 1 [cited 2025 Apr
24];311(6):469–75. Available from: https://doi.org/10.1007/s00403-019-01922-z
2. Isamah CP, Akpomiemie MO, Otene CI. Epidemiology and Pattern of Presentation of Keloids at a Tertiary
Hospital in Southern Nigeria. Niger Health J [Internet]. 2024 Oct 5 [cited 2025 Apr 24];24(3):1535–42.
Available from: https://tnhjph.com/index.php/tnhj/article/view/875
3. Zainib M, Amin NP. Radiation Therapy in the Treatment of Keloids. In: StatPearls [Internet]. Treasure
Island (FL): StatPearls Publishing; 2025 [cited 2025 Apr 24]. Available from:
http://www.ncbi.nlm.nih.gov/books/NBK499973/
4. Swenson A, Paulus JK, Jung Y, Weiss S, Berman B, Peeva E, et al. Natural History of Keloids: A
Sociodemographic Analysis Using Structured and Unstructured Data. Dermatol Ther [Internet]. 2023 Dec
8 [cited 2025 Apr 25];14(1):131–49. Available
from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10828254/
5. Bamikole OJOSHUA. Keloid in Nigeria: More questions than answers. Nig J Child Adol Health [Internet].
2020 Jan 1 [cited 2025 Apr 25]; Available from:
https://www.academia.edu/108796291/Keloid_in_Nigeria_More_questions_than_answers
INTERNATIONAL JOURNAL OF RESEARCH AND SCIENTIFIC INNOVATION (IJRSI)
ISSN No. 2321-2705 | DOI: 10.51244/IJRSI | Volume XII Issue XV November 2025 | Special Issue on Public Health
Page 2759
www.rsisinternational.org
6. Wen P, Wang T, Zhou Y, Yu Y, Wu C. A retrospective study of hypofractionated radiotherapy for keloids in
100 cases. Sci Rep [Internet]. 2021 Feb 11 [cited 2025 Apr 24];11:3598. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878871/
7. Shen J, Lian X, Sun Y, Wang X, Hu K, Hou X, et al. Hypofractionated electron-beam radiation therapy for
keloids: retrospective study of 568 cases with 834 lesions. J Radiat Res (Tokyo) [Internet]. 2015 Sep [cited
2025 Apr 25];56(5):811–7. Availablefrom: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4577000/
8. Cheraghi N, Cognetta A, Goldberg D. RADIATION THERAPY for the Adjunctive Treatment of Surgically
Excised Keloids: A Review. J Clin Aesthetic Dermatol [Internet]. 2017 Aug [cited 2025 Apr 25];10(8):12–
5. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5605209/
9. Abdus-salam A, Orekoya A, Jimoh M, Olabumuyi A. RADIOTHERAPY TREATMENT OF KELOIDS IN
IBADAN. J West Afr Coll Surg [Internet]. 2016 [cited 2025 Apr 25];6(4):104–16. Available from:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5667728/
10. Kouotou EA, Nansseu JR, Omona Guissana E, Mendouga Menye CR, Akpadjan F, Tounkara TM, et al.
Epidemiology and clinical features of keloids in Black Africans: a nested case–control study from Yaoundé,
Cameroon. Int J Dermatol [Internet]. 2019 Oct [cited 2025 May 7];58(10):1135–40. Available from:
https://onlinelibrary.wiley.com/doi/10.1111/ijd.14610
11. Huang C, Wu Z, Du Y, Ogawa R. The Epidemiology of Keloids. In: Téot L, Mustoe TA, Middelkoop E,
Gauglitz GG, editors. Textbook on Scar Management: State of the Art Management and Emerging
Technologies [Internet]. Cham: Springer International Publishing; 2020 [cited 2025 May 7]. p. 29–35.
Available from: https://doi.org/10.1007/978-3-030-44766-3_4
12. Téot L, Mustoe TA, Middelkoop E, Gauglitz GG, editors. Textbook on Scar Management: State of the Art
Management and Emerging Technologies [Internet]. Cham (CH): Springer; 2020 [cited 2025 May 10].
Available from: http://www.ncbi.nlm.nih.gov/books/NBK586066/
13. Ketiku KK, Ekanem e E. The Management of Keloids by Radiotherapy in Nigeria. Niger Q J Hosp Med.
2004;14(2):151–6.
14. Olasode O. A Five Year Retrospective Study of Keloidal Patterns at a Tertiary Skin Clinic in South West
Nigeria. Niger J Dermatol [Internet]. 2018 [cited 2025 May 7];8(1). Available from:
https://nigjdermatology.com/index.php/NJD/article/view/102
15. Udo-Affah GU, Eru EM, Idika CI, Njoku CC, Uruakpa KC. The Age and Sex Incidence of Keloids /
Hypertrophic Scars in Calabar Metropolis, Cross River State from 2001-2006. J Biol Agric Healthc
[Internet]. 2014 [cited 2025 May 7];4(11):33. Available from:
https://iiste.org/Journals/index.php/JBAH/article/view/12925
16. Anaba EL, Akwara I, Johnson O. A prospective study of pattern of keloid and number of intralesional
triamcinolone acetonide injections in a community based dermatology clinic in Lagos, Nigeria. Int J Res
Dermatol [Internet]. 2019 Oct 21 [cited 2025 May 7];5(4):760–4. Available from:
https://www.ijord.com/index.php/ijord/article/view/703
17. Belie O, Ugburo AO, Mofikoya BO. Demographic and clinical characteristics of keloids in an urban center
in Sub-Sahara Africa. Niger J Clin Pract. 2019 Aug;22(8):1049–54.
18. Xu W, Sinaki DG, Tang Y, Chen Y, Zhang Y, Zhang Z. Acne-induced pathological scars: pathophysiology
and current treatments. Burns Trauma. 2024;12:tkad060.
