A 22-year-old woman of Indian ethnicity complained about a spontaneously painful, sessile mass located on the posterior aspect of the ear. The lesion was located at the site of an ear piercing.
Key point: Physical examination revealed a classic keloidal mass associated with piercing designed to accommodate an earring. Because of the lesion’s size, conservative measures—such as intralesional corticosteroid injections—were felt to not likely be of benefit.
Treatment: The keloid was removed by horizontal excision, with preservation of a portion of the surface that was used as an autograft to cover the resulting defect. At the time of closure, and weekly for 8 weeks thereafter, the base and periphery were injected with triamcinolone acetonide (10 mg/mL dilution).
Note: While more common among African Americans, keloids can occur in any ethnic group. Keloids can be intensely painful, and such lesions almost always require removal.