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Pathology · Tissue repair: keloid
Sample itemA 22-year-old woman of dark complexion develops a raised, firm, shiny scar at an ear-piercing site. Over months it has grown well beyond the original wound margins, and it reappeared after simple surgical excision. Which statement describes this lesion?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Thick, hyalinised collagen bundles extending beyond the original wound
A keloid is an exuberant scar in which excessive thick, glassy, eosinophilic collagen extends beyond the boundaries of the original wound. It is more frequent in dark-skinned individuals, may appear after minor trauma, and commonly recurs after excision alone. Hypertrophic scars stay within the wound margins and often regress.
Option by option
A. Scar confined to the wound margins that regresses spontaneously
A scar confined to the wound that regresses describes a hypertrophic scar.
B. Thick, hyalinised collagen bundles extending beyond the original wound (correct)
Correct. Keloids invade beyond the wound edge and are made of thick hyalinised collagen bundles.
C. Excess granulation tissue with exuberant capillaries only
Excess granulation tissue is proud flesh, which is rich in vessels and not collagen-dense.
D. Reduced collagen synthesis with thin disorganised bundles
Reduced collagen synthesis leads to wound dehiscence and not to a keloid.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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