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Background: Different combinations of excision and adjuvant therapies have been applied to improve outcomes for earlobe keloids, though evidence in this field is still lacking. Objectives: This study sought to systematically investigate efficacy and safety of these treatments. Methods: We conducted a systematic search on PubMed, Embase, Web of Science, and Cochrane Library to find all relevant studies. Meta-analysis of recurrence rates (RRs) and adverse event rates with 95% confidence intervals, and individual participants data (IPD) were calculated for each intervention when possible. Otherwise, narrative syntheses were performed. Results: A total of 85 articles, covering 23 treatments for earlobe keloids, were included, indicating a preference for multiple combination therapy. The estimated RRs for 6 interventions (i.e., excision monotherapy, combinations of excision with imiquimod, pressure therapy, radiotherapy, steroids, and steroids with pressure therapy) appeared to be comparable. Electron radiotherapy was found to have potential advantages over X-ray treatment, contributing to the observed heterogeneity. Further meta-analysis using IPD revealed that both combination therapies of excision plus steroid therapy (p=0.003) and excision plus radiotherapy (p=0.003) yielded better recurrence-free survival compared to excision alone. The median recurrence-free interval for combination therapy was 10 months. Adverse event rates were similar among different intervention groups. Conclusions: This study suggests that combining excision with radiotherapy or perioperative steroid therapy has the potential to improve prognosis of earlobe keloids without increasing the risk of adverse events. Overall evaluation of patients' conditions and further studies with sufficient follow-up are warranted for clinical practice. Level of Evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. [ABSTRACT FROM AUTHOR]

Congenital earlobe clefts are the most common lower auricular malformations. They represent a unique reconstructive challenge. The goal of surgery includes restoration of a natural lobular contour and volume as well as a fine surgical scar. Several surgical techniques have been described, most of which only address the cleft deformity but not the soft tissue deficiency. We hereby describe a technique which addresses both the cleft and improves soft tissue deficiency through a conchal cartilage graft. [ABSTRACT FROM AUTHOR]

Merkel cell carcinoma (MCC) is an aggressive neuroendocrine carcinoma with a high rate of metastasis. MCC is rarely suspected during clinical examination, thus requiring biopsy to establish a pathologic diagnosis. In addition, MCC sometimes occurs in double primary cancers. Although there have been reviews on double primary cancers, only a few cases involving MCC have been described. Herein, we report a case of a 54-year-old female patient who presented to our clinic with a diagnosis of earlobe MCC following an excisional biopsy performed by another clinic. Further evaluation, including chest imaging, revealed a mass in the lung. The patient underwent a wide excision of the right earlobe, and video-assisted thoracic surgery on the lung. Pathology confirmed MCC in the right earlobe and adenocarcinoma in the lung. The patient underwent postoperative adjuvant chemotherapy followed by radiotherapy. Up to this point, 3 years after the surgery, there has been no evidence of recurrence. [ABSTRACT FROM AUTHOR]

Lobule transposition, a common procedure in auricle reconstruction, has been successfully performed over the past few decades. However, the transposition methods for unilateral microtia with evident asymmetry of bilateral earlobe positions still remain a challenge. The objective of this study was to investigate the application of prograde transposition for anteriorly low-set earlobes. A total of 25 patients with lobule-type microtia with anteriorly low-set residual earlobe underwent prograde transposition during auricle reconstruction between 2020 and 2022. The post-operative earlobe aesthetic assessment and patient satisfaction were evaluated, and the data on any complications that occurred when followed-up were collected. This study provides a comprehensive analysis and summary of the techniques used in earlobe transposition for auricular reconstruction. The patients with evident asymmetry between the residual and healthy earlobes were usually concomitant with hemifacial microsomia and the residual ear was located in the anterior and lower region. No instances of flap necrosis, hematoma, or wound dehiscence were observed following auricular reconstruction. The mean aesthetic score of the auricle was 3.52, with 23 patients attaining good or excellent aesthetic outcomes. The mean Visual Analog Scale satisfaction score was 3.68, with 24 patients reporting relative satisfaction or satisfaction. The prograde transposition of anteriorly low-set earlobe in lobule-type microtia reconstruction can effectively ensure adequate blood supply, enhance aesthetic appearance, and significantly improve patient satisfaction. [Display omitted] [ABSTRACT FROM AUTHOR]

Background Massive earlobe scarring/keloid formation can occur after ear piercing in individuals of African descent. Case report: A 14-year-old African girl with pierced ears in childhood presented with two progressively growing and disfiguring tumors on both earlobes. The maximum diameter of each lesion was 5.5 centimeters, and the weight of each lesion was approximately 20 grams. Histologically, there was a mixed pattern of keloid and hypertrophic scarring. Discussion: Massive keloids can occur after ear piercing in childhood. It is unclear why some individuals develop these massive keloids. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate frequency of attached earlobes (dominant) and unattached earlobes (recessive) traits in humans of different age groups. This study was conducted in the Department of Molecular Biology and Genetics of Shaheed Benazir Bhutto University, Shaheed Benazir Abad from September to October 2020. A total of 200 families with attached and unattached earlobes were included by using non-probability convenient sampling. Data was collected regarding attached and unattached earlobes of different people. The data was collected and analysed by using SPSS version 21.0. Results of the study suggested that unattached earlobes were dominant feature, and the attached earlobe feature appears to be recessive among all 200 families. We observed that the dominant feature of the unattached earlobe was more common in the 1 to 20 years’ age group, while the recessive feature of the attached earlobe was common in 31 to 45 years old age group. The study concluded that unattached earlobes can be observed in people of every age group and associated with family traits.

Pilomatricoma is a rare cutaneous epidermal appendageal tumour having differentiation in the direction of hair cortex cells. It usually presents as single, less than 3 cm size, subcutaneous lesion, commonly seen in children, more commonly in head, neck and upper extremities. It can mimic a variety of other lesions clinically as well as cytologically, thereby posing a diagnostic challenge. The ear lobe is a very rare site for it to occur. The authors report a case of a 61-year-old female presented with history of non tender nodule on left ear lobe for six months. The lesion was clinically suspected as keloid, sebaceous cyst and chondroma, later diagnosed as pilomatricoma on fine needle aspiration cytology, confirmed further on histopathological examination. Sebaceous cyst has been ruled out due to the presence of characteristic findings in both cytology and histopathology. However, due to the inherent disadvantage of cytology, predominance of one component over the other would have mislead the diagnosis. It is being reported for its rare location, unusual age of presentation and to report its mimics on cytology.

BACKGROUND: Drawing blood from the fingertips for glucose testing is painful and likely to cause tissue damage over time. Earlobes are an alternative site for glucose measurement. OBJECTIVE: This work aims to validate the earlobe as an alternate test site for blood glucose testing by demonstrating valid and reliable statistically significant differences between the earlobes and standard reference sites. METHODS: Blood glucose concentrations from 50 volunteers were measured and statistically analysed from the reference sites (forearm and fingertip) and earlobe. The analysis included: 1) one-way analysis of variance (ANOVA), 2) regression analysis, 3) Bland Altman analysis, and 4) Clarke Error Grid analysis. RESULTS: The results indicated that there is no statistically significant difference between the three blood glucose-testing methods. For the forearm-earlobe and fingertip-earlobe, all measurements were grouped around the mean of 3.7 ± 1.96 SD and 2.96± 1.96 SD, respectively. Error grid analysis showed > 97% of all earlobe and references measurements fell in Zones A and B and were in the clinically acceptable level. CONCLUSIONS: The results have shown that the earlobe is a valid substitute for blood glucose measurements. [ABSTRACT FROM AUTHOR]

Objective: Congenital anomalies of the external ear may present a reconstructive challenge, particularly when normal chondrocutaneous components of the auricle fail to develop. Our goal was to develop a novel technique for lobule reconstruction of a congenitally absent earlobe with photographic documentation of the technique. Methods: Informed consent for perioperative photography and publication of case details was obtained. A postauricular, turnover flap with ipsilateral conchal cartilage grafting was performed to reconstruct the lobule, and a superiorly based, postauricular, rotation advancement flap was used to close the donor site defect. Results: Perioperative photographs are included demonstrating technique and cosmetic results. Conclusions: Malformations rarely involve the lobule or lower third of the ear primarily. Literature regarding lobule reconstruction for congenital malformations is scarce. We present a novel technique for lobule reconstruction of a congenitally absent earlobe performed in a single stage that avoids a visible neck scar and allows for simultaneous conchal cartilage harvest. The technique demonstrated satisfactory cosmesis regarding contour and overall appearance and these results remained stable at 1-year follow up. [ABSTRACT FROM AUTHOR]

Competing Interests: Conflicts of interest None disclosed.

Background: The prevalence of ear piercings is 8%-32%. Complications can be due to the factors such as the amount of tissue blood supply, the location of the piercing, the extent of hygiene techniques, and much more. Materials and Methods: A total of 586 females (age, 18-28 years) in Riyadh, Saudi Arabia, with at least one ear piercing were included in this analytical cross-sectional study by convenience sampling from September 2019 to April 2020. A link to an Arabic web-based questionnaire was distributed through social media (WhatsApp, Twitter, and Snapchat). It included questions related to both earlobe and ear cartilage piercings. Bivariate statistical tests were carried out. Results: The prevalence of a probable ear piercing-related infection for ear cartilage piercings was found to be significantly higher than for earlobe piercings (41.4% vs. 29.6%) (P = 0.0004) (confidence interval [CI] = 0.443-0.795). A significant association between piercing type (3.3% of earlobe piercings and 8.1% of ear cartilage piercings) and scar formation was observed (P = 0.0002) (CI = 0.209-0.722). The prevalence of ear piercing complications among participants who used piercing needles was lower for both earlobe piercings and ear cartilage piercings (3.65%, 8.75%) (P = 0.0015) than among those who used piercing guns (37.9%, 43.4%) (P = 0.114). Conclusion: Probable external ear infections were more common among those with cartilage ear piercings than those with earlobe piercings. Future studies should include participants of a broader age category and in different locations in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Pilomatricoma is a rare cutaneous epidermal appendageal tumour having differentiation in the direction of hair cortex cells. It usually presents as single, less than 3 cm size, subcutaneous lesion, commonly seen in children, more commonly in head, neck and upper extremities. It can mimic a variety of other lesions clinically as well as cytologically, thereby posing a diagnostic challenge. The ear lobe is a very rare site for it to occur. The authors report a case of a 61-year-old female presented with history of non tender nodule on left ear lobe for six months. The lesion was clinically suspected as keloid, sebaceous cyst and chondroma, later diagnosed as pilomatricoma on fine needle aspiration cytology, confirmed further on histopathological examination. Sebaceous cyst has been ruled out due to the presence of characteristic findings in both cytology and histopathology. However, due to the inherent disadvantage of cytology, predominance of one component over the other would have mislead the diagnosis. It is being reported for its rare location, unusual age of presentation and to report its mimics on cytology. [ABSTRACT FROM AUTHOR]

Pseudocysts of the ear are asymptomatic noninflammatory cystic enlargements without pain, are idiopathic, and relatively rare, usually located in the lateral or posterior region of the earlobe. The definitive etiology is still unclear, but it is thought that constant compressed trauma to the earlobe can be a trigger for the pseudocyst's development. Management is mainly carried out to achieve complete resolution, preventing the possibility of recurrence and maintaining the structure of the auricle. Corticosteroid injection, needle aspiration, and suppression techniques are common management modalities. Bolster compression technique is an emphasis on both sides using gauze. There were two cases of patients reported who performed procedures with a bolster. The first case was a 35-year-old male patient with right ear pseudocyst. The second case was a 49-year-old male patient with recurrent right ear pseudocysts. Management of ear pseudocysts with suppression using a bolster is safe and effective, inexpensive, and has minimal risk for recurrence. [ABSTRACT FROM AUTHOR]

BACKGROUND: The ear is an important cosmetic structure. Acquired traumatic defects of the earlobe can be classified into two categories: complete and incomplete. Because of the recent increase in perforations and earlobe expanders, wide tear lobe or elongation defects need proper reconstruction with special surgical techniques. CLINICAL CASE: A 48-year-old female patient with complete double unilateral earlobe tear, successfully treated with M-Z-plasty. CONCLUSIONS: We did not find any reported case of a defect with double elongation of the atrial lobe; for this reason, we propose a modification to the current classification with integration of type V, which corresponds to the case described. [ABSTRACT FROM AUTHOR]

The rational of conservation and sustainable use of indigenous chicken (IC) resources requires their morphobiometrical characterisation. This study morphobiometrically characterised the IC ecotypes in Rwanda. The morphological features and zoometric measurement data were randomly collected on 1670 mature IC of both sexes from five ecotypes of Rwanda. The nonparametric Kruskal–Wallis and Mann–Whitney U test were used in evaluating the effect of ecotypes on the qualitative morphological variables. Zoometric measurements were analysed with the PROC GLM of SAS. The findings showed that the feather morphology and distribution were mainly normal (98.3 and 84.40%, respectively) while feather colour was dominated with multicoloured (38.10%). The majority of the birds had red earlobe (49.20%), yellow shanks (53.80%) and single comb-type (71.70%). These parameters were different (p < 0.05) between the ecotypes. Bodyweight and linear body measurements were highly different (P < 0.001) between ecotypes. Differences associated with sex (P < 0.001) were observed in body weight and linear body measurements. The interaction between ecotype and sex significantly (P < 0.001) influenced body weight, body length, shank length, comb length, comb height, wattle length, chest circumference, neck length and wingspan. The IC ecotypes in Rwanda were found to be diverse morphobiometrically both in quantitative and qualitative traits. These variations provide a foundation for classification of the chicken into breeds. [ABSTRACT FROM AUTHOR]

Basal cell carcinoma (BCC) development in the context of a piercing is a rare phenomenon, reported in the literature in only six instances. We present a 55-year-old woman with nodular BCC involving her auricular piercing and extending clinically onto the Posteroinferior right ear lobule and right postauricular crease. Histological analysis revealed spread of the BCC through the piercing onto the anterior lobule, with evidence that the cancer utilized the piercing as a low resistance pathway for this microscopic invasion. This case is, to our knowledge, the first report of microscopic BCC present within an auricular piercing itself. Chronic inflammation related to repeated trauma from the embedded jewelry may have played a role in its formation. A piercing may provide a path of least resistance for BCC tumor cells to invade, providing a nidus for recurrence. Careful histological examination with possible complete excision of the piercing is prudent to prevent cancer return. [ABSTRACT FROM AUTHOR]

Keloids occur as a result of abnormal wound healing and as many as 70% of keloids and hypertrophic scars affect the pediatric population. Earlobe keloids, similar to lesions elsewhere in the body, remain a challenging problem given the high rates of recurrence and lack of consensus regarding treatment strategy. This study aims to evaluate the outcomes and patterns of recurrences following treatment of earlobe keloids in a large cohort of pediatric patients to facilitate identification of the optimal treatment strategy. All pediatric patients who underwent surgical therapy for earlobe keloids over a 10-year period (2004–2015) were identified and demographic, clinical and outcomes data were collected. A follow-up phone survey was administered to assess rates of long-term recurrence and overall satisfaction with the treatment strategy. Data analysis was performed using Student's t-test and Fisher's exact as appropriate. A total of 94 patients with 135 keloids were identified. Mean age was 14 years with slight preponderance of females (52%) and a majority (75%) of the patients were African American (AA). Mean keloid size was 2.4 cm (0.25–11 cm) with ear piercing being the most common inciting etiology. Excision with steroid injection (59%) was the most frequent treatment approach followed by excision alone (25%). During a median follow up of 2 years, keloid recurrence occurred in 27 (28.7%) patients, 19 (70.4%) underwent additional therapy with 10 (52.6%) re-recurrences noted. Median time to recurrence was 23 months, with a slightly higher recurrence rate in AA patients (32%; p = 0.26) and in those age < 10 years (50%; p = 0.11). This represents the largest series of earlobe keloids treatment in children. Our data suggest that recurrence rates are unaffected by the age at excision and race of the patient. Moreover, adjuncts to excisional therapy such as steroid injection, compression therapy and radiation also did not appear to influence recurrence. Given the pattern of recurrences studies with longer term follow-up are needed to assess the efficacy of treatment strategies. Case series. IV [ABSTRACT FROM AUTHOR]

Hardy-Weinberg equilibrium is the study of the distribution of allelic and genotypic frequencies in a population. The objective of this study is to evaluate the allelic and genotypic frequency of different qualitative traits of men and women in Punjab, Pakistan. A total of 909 individuals were recruited for this study. In population, the frequency order of the blood group is B > O > A > AB and the same in both males and females. Rh-positive is more elevated (86.03%) than the negative (13.97%) in the whole population. Tongue rolling ability is higher in both males (58.92%) and females (61.46%). The presence of free earlobe (71.29%) and straight hairs (52.81%) is more in the whole population. Straight hair is more common in the population than the wavy (30.14%) and curly (17.05%), the male and female order is the same as in the whole population. In the whole population, the ear lobe is non-significant but other traits are significant. This study indicated that the alleles for the ear lobe are in equilibrium in the population, based on a Mendelian ratio. Hence, only the ear lobe follow the Mendelian ratio in the population of Punjab, Pakistan. [ABSTRACT FROM AUTHOR]

Abstract Background Neuropsychological effects of considerably low levels of lead exposure are observed in children, and a reliable and possibly painless technique that can detect such levels is required for the assessment of such exposure. We examined whether the blood lead (BPb) concentrations obtained from the earlobe were as valid and useful as those from the median cubital vein. Methods Paired blood samples were collected from the earlobe and cubital vein of 112 Japanese participants occupationally unexposed to lead, and the BPb levels were determined using ICP-MS. Results The limit of detection of BPb for the ICP-MS method was 0.015 μg/dL, and there was no participant with a BPb level below this limit. The median values of BPb concentrations were 0.91 (range, 0.41–2.48) μg/dL for earlobe blood using a 175-μL capillary tube and 0.85 (0.35–2.39) μg/dL for venous blood using a 5-mL vacuum tube. There was a significant correlation between the earlobe BPb levels and cubital vein BPb levels (Spearman rank correlation r S = 0.941), though the earlobe BPb levels were significantly higher than the cubital vein BPb levels. Most of the participants regarded earlobe puncture as a painless method. Conclusions These data suggest that earlobe BPb levels can be used to assess lead exposure in children. Blood collection using a capillary tube should be done carefully and promptly because slow withdrawal may lead to measurement bias.

Introduction: Milia en plaque is an uncommon benign dermatosis. Case presentation: We present a case of a 43-year-old Caucasian man with a five-month history of asymptomatic symmetric lesions on the earlobes that has been previously treated by self-medication with potent topical steroids, emollients, cosmetic procedures, herbal medication and punch-procedure. Based on clinical examination, a diagnosis of milia on earlobes was established and treated with topical steroids. Conclusions: Milia en plaque of the earlobes has yet not been reported. Treatment is not different from other localizations. [ABSTRACT FROM AUTHOR]

Earlobes, nasal cavities, and fingers of 145 healthcare workers in convalescent and rehabilitation hospital (60 nurses and 85 rehabilitation healthcare workers) were sampled. Of the 3 sites sampled, Staphylococcus aureus was detected in one or more sites in 25 nurses and 27 rehabilitation workers. S. aureus was detected in all 3 sites in 2 (8.0%) nurses and 2 (7.4%) rehabilitation workers, and the S. aureus isolates in each case showed related PFGE pattern. S. aureus was detected in both the fingers and nasal cavities of 5 (18.5%) of the rehabilitation healthcare workers; in all 5 cases, the PFGE patterns of the S. aureus isolates from each site belonged to same cluster based on PFGE. Of the 2 cases in which methicillinresistant S. aureus (MRSA) was recovered from earlobes, fingers, and nasal cavities, in both cases, MRSA isolates from the 3 sites were the same clone according to PFGE analysis and SCCmec type IV. As S. aureus was detected in pierced earlobes of nurses, hand hygiene must be practiced after touching pierced earlobes and before patient contact. The same S. aureus clone in the nasal cavity and earlobes indicates that the route of transmission is through the fingers.

Keloid resection followed by adjuvant radiotherapy is the most efficacious treatment for keloids. However, for earlobe keloids, an optimal protocol for the total dose and fractions of adjuvant radiation has not yet been established. We retrospectively analyzed the efficacy and safety of immediate three-fraction electron radiotherapy after operation for resistant earlobe keloids. From 2011 to 2017, three-fraction electron radiotherapy with single dose of 5 Gy was given postoperatively to 23 patients with 30 keloids in our hospital. The first fraction of adjuvant radiotherapy was administered within 2 h of surgery, and the other two sessions were completed within the next day or two. Five (16.7%) primary keloids and 25 (83.3%) recurrent keloids were examined in this study. The primary endpoint was the local control rate, which was 86.7% after a median follow-up of 26 months (14–93 months). Secondary endpoints were acute and late procedure-related complications, and no severe complications were observed after combination therapy. Our results suggest that three-fraction electron radiotherapy after excision within 2 days of surgery is a safe and effective protocol for the prevention of earlobe keloid recurrence that can also improve patient compliance and comfort. [ABSTRACT FROM AUTHOR]

Earlobe elongation is one of the signs of aging process and surgical correction is warranted for earlobe ptosis. Most of the earlobe reduction techniques result with scars on the anterior or inferior aspect of the earlobe or unnatural appearance. The authors present a modified technique for earlobe reduction and reshaping that results with an acceptable scar set on the natural groove of the anterior surface of the earlobe. Nine healthy female patients were operated for earlobe reduction. The postoperative and preoperative otobasion inferius (O)–subaurale (S) distances of these patients were evaluated. According to the measurements, the preoperative mean O–S distance of the right lobule was 13.1 ± 1.8 mm and the left lobule was 12.8 ± 1.9 mm, while the postoperative O–S distance of the right side was 3.4 ± 1 mm and the left side was 3.4 ± 0.7 mm ( Table 2 ). This translated to an approximate pre- and postoperative O–S distance difference of 9 mm, a significant reduction that resulted with ideal O–S values. The presented approach has numerous advantages including inconspicuous scarring, smooth lateral earlobe contours, and undisturbed free borders. This was a Level IV therapeutic study. [ABSTRACT FROM AUTHOR]

Highlights • S. aureus was recovered from earlobes of nurses who had pierced earring hole. • 50% of S. aureus positive in earlobe nurse were also be positive on their fingers. • Contaminated pierced earlobes with S. aureus can be a source of HAI. Background In recent years, the wearing of pierced earrings for personal adornment has increased among health care workers in Japan. However, the transmission dynamics between bacteria in pierced earring holes and fingers has not been clearly shown. Methods Earlobes and fingers of 200 nurses (128 nurses with pierced earlobes and 72 nurses with unpierced earlobes) working at a university hospital were sampled to determine whether cross-transmission of bacteria-colonized pierced earring holes and fingers in nurse is possible. Results Of 128 nurses who had pierced earring holes, Staphylococcus aureus was recovered from earlobes of 24 nurses (18.8%) compared with 7 of 72 nurses without pierced earring holes (9.7%) (P =.09). Of those 15 nurses yielding S aureus from both earlobes and fingers, 12 were from nurses who had pierced earring holes compared with 3 nurses without pierced earring holes. Excluding 1 nurse, antimicrobial susceptibility patterns and genotypes of S aureus from both earlobe and fingers of each nurse were identical. Conclusion Pierced earlobes can be a source of health care-associated infection via cross-transmission of bacteria from earlobe holes to fingers. [ABSTRACT FROM AUTHOR]

Background: Keloids of the ear are common problems. Various treatment modalities are available for the treatment of ear keloids. Surgical excision with intralesional steroid injection along with compression therapy has the least recurrence rate. Various types of devices are available for pressure therapy. Pressure applied by these devices is uncontrolled and is associated with the risk of pressure necrosis. We describe here a simple and easy to use device to measure pressure applied by these clips for better outcome. Objectives: To devise a simple method to measure the pressure applied by various pressure clips used in ear keloid pressure therapy. Materials and Methods: By using a force sensitive resistor (FSR), the pressure applied gets converted into voltage using electrical wires, resistors, capacitors, converter, amplifier, diode, nine-volt (9V) cadmium battery and the voltage is measured using a multimeter. The measured voltage is then converted into pressure using pressure voltage graph that depicts the actual pressure applied by the pressure clip. Results: The pressure applied by different clips was variable. The spring clips were adjustable by slight variation in the design whereas the pressure applied by binder clips and magnet discs was not adjustable. Conclusion: The uncontrolled/suboptimal pressure applied by certain pressure clips can be monitored to provide optimal pressure therapy in ear keloid for better outcome.

Keloids grow and do not regress. They are characterised histologically by hyalinised keloidal collagen ( HKC). HKC amounts vary, and the mechanism by which they form is unclear. To clarify how HKCs form and whether their formation associates with specific clinical features, we studied the histological findings of earlobe keloids and compared them with respective clinical features. A total of 50 earlobe keloids from 43 patients were used for histological analysis of keloid size (mm2), HKC area (mm2) and HKC area ratio (%). As a result, keloid durations ranged from 3 months to >13 years. Early-stage keloids exhibited little HKC and a tendency for the HKCs to locate in perivascular regions. In later-stage keloids, the HKCs were extremely interconnected and formed a thick bitten donut-shaped region. HKC area ratios correlated positively with keloid duration ( r2 = 0·58, P<0·05). HKC area ratios and keloid durations did not correlate with keloid sizes. These patterns of HKC formation and growth may explain why local therapies, which effectively remove fibroblasts and accumulated collagen but not HKCs, are ineffective in older keloids. Keloids should be promptly treated after diagnosis, and older keloids with extensive HKCs may require surgical excision followed by radiotherapy. [ABSTRACT FROM AUTHOR]

Background: Ptosis of the earlobe is a common consequence of ageing, defined as an unappealingly large free caudal segment of over 5 mm. It is therefore important to consider reduction as a complement to rhytidectomy in selected patients. Moreover, facelifting operations can result in disproportionate or poorly positioned earlobes. Current earlobe-reducing techniques can leave a scar on the free lateral edge causing notching or involve complex pattern excisions with limited resection capability and the risk of deformities. The presented technique, on the other hand, is versatile and easy to use, as it follows general geometric principles. Methods: Excision of the designed area results in an earlobe flap which can be rotated in the excision defect. This results in ideal scar locations, situated at the sub-antitragal groove and at the cheek junction. The technique is adjustable, to incorporate potential piercing holes. Results: This technique takes approximately 15 minutes per earlobe to complete. The resulting earlobes have undisturbed free borders. No vascularization-related flap problems were noted. Conclusions: This technique is a viable method for reducing the earlobe with minimally visible scars. Level of evidence IV: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors . [ABSTRACT FROM AUTHOR]

Keloid is an unregulated proliferation of fibrous scar tissue that develops outside the original wound; as well as secondary to trauma or infection, it can appear spontaneously. Ear piercing is the most frequent risk factor for keloid formation. A case of keloid of the ear lobe is described in a teenager after a second ear piercing performed at age 13. The girl had already undergone two traditional surgical treatments. Dermatological examination showed an extended and pruritic keloid of the lobe and auricle. After obtaining an informed consent from the parents, we decided to implement a combined treatment, adding to the intralesional surgical removal corticosteroid therapy for local injection and pressotherapy, applying continuous pressure with an ear clip. After 18 months from the operation, the girl had no recurrences with a good clinical and esthetic result. Although this combined therapeutic strategy seems effective, prevention, raising awareness among both patients and parents about the possible formation of keloids, remains the most effective option. [ABSTRACT FROM AUTHOR]

Summary: Background: Earlobe deflation caused by fat atrophy is normally treated with lipofilling, mostly in the context of facelift surgery. In this report, we aim at reporting on Hyaluronic Acid injections to treat earlobe deflation. Materials and Methods: 16 Mowlavi Grade I and II patients were treated with HA injections, followed by molding to shape the lobule. Results: Effective correction, lasting 14 months on average, is achieved. Five patients needed a touch‐up procedure after 4‐6 months to improve the result. Conclusions: Earlobe augmentation with HA is an ideal option for correction of earlobe atrophy in cases of Mowlavi Grades I and II ptosis. Long‐lasting (about 14 months) correction is achieved with no downtime. [ABSTRACT FROM AUTHOR]