Inflammation and repair: keloid versus hypertrophic scar: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Inflammation and repair: keloid versus hypertrophic scar

Sample item

A 22-year-old develops a raised scar after ear piercing that grows well beyond the original wound margin and recurs after excision. Which histological feature is characteristic?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Thick, hyalinised, glassy eosinophilic collagen bundles

Keloids show thick glassy hyalinised collagen bundles and extend beyond the wound edge, unlike hypertrophic scars which stay within it and may regress. Excision alone has a high recurrence rate.

Option by option

  • A. Whorled spindle cells with mitoses

    Whorled spindle cells with mitoses suggest a fibrosarcoma or fibromatosis, not a scar.

  • B. Thick, hyalinised, glassy eosinophilic collagen bundles (correct)

    Correct. Thick hyalinised eosinophilic collagen bundles typify a keloid.

  • C. Collagen with regular thin parallel orientation

    Thin parallel collagen is seen in an ordinary mature scar.

  • D. Granulation tissue with abundant neutrophils

    Neutrophil-rich granulation tissue belongs to early acute wound healing.

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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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, Thick, hyalinised, glassy eosinophilic collagen bundles. Keloids show thick glassy hyalinised collagen bundles and extend beyond the wound edge, unlike hypertrophic scars which stay within it and may regress.

Why is "Whorled spindle cells with mitoses" not the answer?

Whorled spindle cells with mitoses suggest a fibrosarcoma or fibromatosis, not a scar.

Why is "Collagen with regular thin parallel orientation" not the answer?

Thin parallel collagen is seen in an ordinary mature scar.

Why is "Granulation tissue with abundant neutrophils" not the answer?

Neutrophil-rich granulation tissue belongs to early acute wound healing.

What concept does this question test?

It tests Inflammation and repair: keloid versus hypertrophic scar in Pathology. Excision alone has a high recurrence rate.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Inflammation and repair: keloid versus hypertrophic scar?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.