Patient-reported outcomes for keloids: A systematic review

Andrea Tan, Donald A. Glass

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


INTRODUCTION: Keloids are exuberant responses to cutaneous wound healing. Many research studies utilize keloid recurrence, scar thickness, and objective physician-reported data as outcome measures. Patients may have different perceptions and evaluations of treatment success from physicians, however. This review discusses available patient-reported outcome measures for keloids, as well as patient-reported outcomes across current treatment modalities. EVIDENCE ACQUISITION: A literature search of PubMed, Ovid/Medline, and EMBASE was conducted from inception to April 2018. Studies involving the evaluation of keloids with at least one patient-reported outcome measure were included. EVIDENCE SYNTHESIS: 30 relevant studies were identified. Topics included patient-reported outcome measures, health-related quality of life, and treatment options such as: topical treatments, intralesional treatments, cryotherapy, postsurgical intralesional treatments, postsurgical pressure therapy, postsurgical radiotherapy, and postsurgical brachytherapy. The Patient and Observer Scar Assessment Scale (POSAS) was used by 21 (70%) of the included studies. Patient component scores did not correlate well with observer component scores in 7 studies using the POSAS, with 4 studies having significantly worse patient scores. Quality of life in keloid patients was significantly worse compared to controls in 3 studies. Multimodal treatment options generally received more positive patient-reported outcomes. CONCLUSIONS: Patient-reported outcomes provide valuable insights into the perceptions, treatment goals, and quality of life of keloid patients. Development of more patient-reported outcome measures specific to keloids, especially those that incorporate both scar and quality of life assessments, may help refine our current understanding of keloid management.

Original languageEnglish (US)
Pages (from-to)148-165
Number of pages18
JournalGiornale Italiano di Dermatologia e Venereologia
Issue number2
StatePublished - Apr 2019


  • Keloid
  • Patient satisfaction
  • Patient-reported outcome measures
  • Quality of life

ASJC Scopus subject areas

  • Dermatology


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