{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:34:16Z","timestamp":1777563256873,"version":"3.51.4"},"reference-count":9,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T00:00:00Z","timestamp":1752969600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,7,20]],"date-time":"2025-07-20T00:00:00Z","timestamp":1752969600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"abstract":"<jats:p>Giant recurrent auricular keloids, particularly those complicated by donor-site involvement, present significant therapeutic challenges due to aggressive fibroblast biology and high recurrence rates. We report a complex case of a 15-year-old female who developed a massive recurrent auricular keloid with associated abdominal donor-site keloid following otoplasty and subsequent skin grafting. Initial otoplasty at age 10 was complicated by keloid formation, requiring excision and abdominal full-thickness grafting. By age 15, she presented with a recurrent auricular keloid causing auricular deformity, tragus distortion, and external auditory canal obstruction, alongside a donor-site keloid. Management involved the radical excision of both keloids. To minimize tension-induced recurrence, the auricular wound underwent deliberate secondary intention healing, while the abdominal site was closed primarily under minimal tension. Adjuvant therapy comprised 6 weekly intralesional interferon-gamma (IFN-\u03b3) injections (1 million units auricle; 0.5 million units abdomen). This multimodal approach leveraged IFN-\u03b3\u2019s antifibrotic properties, including ferroptosis induction in keloid fibroblasts. At 1-year follow-up, both sites exhibited sustained remission with good fibrosis and acceptable cosmesis without recurrence. This case demonstrates that tension-free excision with secondary intention healing, combined with intralesional IFN-\u03b3, offers a promising strategy for managing complex pediatric keloids where conventional therapies carry substantial limitations. The protocol effectively addresses both biological recurrence drivers and psychosocial burdens inherent to disfiguring scars.<\/jats:p>","DOI":"10.1177\/01455613251358656","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T04:50:38Z","timestamp":1753073438000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["An Unusually Huge Keloid Complicating a Unilateral Otoplasty"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7260-5613","authenticated-orcid":false,"given":"Adel","family":"Azar","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Al Mouwasat University Hospital, Damascus University, Damascus, Syria"},{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6479-8547","authenticated-orcid":false,"given":"Ahmad","family":"Alkheder","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Al Mouwasat University Hospital, Damascus University, Damascus, Syria"},{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"},{"name":"Department of Plastic Surgery, Al Mouwasat University Hospital, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmad","family":"Mustafa","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Al Mouwasat University Hospital, Damascus University, Damascus, Syria"},{"name":"Faculty of Medicine, Damascus University, Damascus, Syria"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,7,20]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0383-0"},{"issue":"4","key":"e_1_3_3_3_2","first-page":"271","article-title":"Epidemiology of skin diseases in people of color","volume":"71","author":"Taylor SC","year":"2003","unstructured":"Taylor SC. Epidemiology of skin diseases in people of color. Cutis. 2003;71(4):271-275.","journal-title":"Cutis"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000005086"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASW.0000451340.59196.9d"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.14413"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41420-025-02401-3"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12722"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/01455613251333673"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-1059-8"}],"container-title":["Ear, Nose &amp; Throat Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613251358656","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01455613251358656","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613251358656","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:38:54Z","timestamp":1777401534000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01455613251358656"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,20]]},"references-count":9,"alternative-id":["10.1177\/01455613251358656"],"URL":"https:\/\/doi.org\/10.1177\/01455613251358656","relation":{},"ISSN":["0145-5613","1942-7522"],"issn-type":[{"value":"0145-5613","type":"print"},{"value":"1942-7522","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,20]]},"article-number":"01455613251358656"}}