In early lesions, it may be impossible to make this distinction, but in developed lesions, the features listed in Table 43-2 are useful.
| Table 43-2. Clinical Features That Distinguish Hypertrophic Scars from Keloids |
| | HYPERTROPHIC SCAR | | KELOID |
| | Any age group, especially children | | Adolescents and young adults |
| | All racial and ethnic groups | | Blacks and Asians > Caucasians |
| | No familial tendency | | Familial tendency |
| | Limited to sites of trauma | | Sites of trauma or spontaneous |
| | Onset within 2 months | | Onset within 1 year |
| | Any anatomic site | | High-risk anatomic site |
| | Dome-shaped lesions | | Dome-shaped, exophytic, or crablike extensions |
| | Confined to site of trauma | | Extends into normal skin |
| | Improved by corrective surgery | | Often worsened by surgery |
| | Spontaneous regression | | No spontaneous regression |
