Pearls in Dermatology How I treat small earlobe keloids with intralesional cryosurgery

Tuen Mun Social Hygiene Clinic, 5/F Tuen Mun Eye Centre, 4 Tuen Lee Street, Tuen Mun, N.T., Hong Kong Treatment of keloids is difficult and the response to first line treatment including silicone gel sheet, compression, topical and intralesional steroid are variable. Intralesional cryosurgery (ILC) may be useful for treating some earlobe keloids not responsive to these first line treatments. ILC is accomplished by continuous delivery of liquid nitrogen through a spinal cannula introduced into the keloid. Each treatment aims to freeze the keloidal core without affecting the surrounding skin. In properly selected lesions, reduction of keloid size is often observed with few complications.