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Difference between hypertrophic scar and keloid

Hypertrophic scar :

  • Scar not raised or only minimally raised above skin surface as the overgrowth of scar tissue is confined to skin edges.
  • The scar crossing normal skin creases or Langer's line is susceptible to become hypertrophic.
  • Margins do not tender to touch and the patient may not have itching.
  • Histologically no eosinophilic hyaline collagen fibres.

Keloid :

  • As overgrowth of fibrous tissue extends beyond the original wound into the normal tissues-scar is raised well beyond the skin surface.
  • Predisposing factors are Negro race, Tuberculosis, pregnancy state, scars over certain parts of the body like anterior chest wall, ear lobule, and post-burn scars.
  • Margins tender and itching is very common.
  • Characteristically seen in histopathological slides showing eosinophilic hyaline-like collagen fibres.
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