I read with great interest the article by Bran et al titled “Auricular Keloids: Combined Therapy With a New Pressure Device.”1 The authors introduce the novel adjuvant pressure therapy for ear keloids using a newly designed, custom-fitted pressure device combined with surgical excision and subsequent intralesional corticosteroid injection. They are to be commended for their efforts.
Keloids are often resistant to treatment and have high recurrence rates, and much of the history of postoperative adjuvant therapies has centered on prevention of keloid recurrences.2 Surgical excision followed by postoperative pressure therapy provides reasonably positive results in the reviewed literature.3 The proposed main mechanism of pressure therapy include hypoxia leading to fibroblast degeneration and collagen degradation. My institution previously reported the use of our novel adjuvant pressure therapy using magnets after surgical excision for treatment of 1436 ear keloids of 883 patients, with a significantly lower rate of recurrences (94 of 883 patients).3 The applied pressure was 35 mm Hg, which was estimated using a digital manometer. Characteristics of magnet that we have used are as follows: density, 7.4 g/cm3; diameter, 10 mm; and thickness, 2 mm. Patients were instructed to use the magnets for 12 hours per day (broken into 2 hours of magnet application followed by a half hour of relief). The magnets should be applied only when the patient's compliance is assured. Otherwise, despite its rarity, tissue necrosis may occur owing to continuous application of magnets without relief.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Figure 1. Ear keloid. External appearance of Magsil pressure device.
Figure 2. Ear keloid. Magsil pressure device applied to both surfaces of the earlobe.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Facial Plastic Surgery editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.