Figure 1.

Keloid scar development. Shown are photos of the same patient illustrating the rapid development of keloid lesions over time after skin injury. The patient, an African American male who sustained a 15% total body surface area burn at 15 years of age, developed widespread keloid lesions in both grafted and ungrafted burn wounds, as well as donor sites used for autograft harvesting. (A–C) Images of patient's left shoulder, showing a healed partial-thickness burn wound that was not grafted. Note the rapid development of large keloid with typical bulging appearance. (D–F) Images of patient's right shoulder; this deeper burn wound was treated with split-thickness skin autograft. Note the development of keloid scarring around the skin graft and within the grafted area where wounds appear to have occurred. Photographs were taken at PBD 72 (A, D), PBD 114 (B, E), and PBD 332 (C, F). PBD, postburn day. Color images are available online.