Extensive keloid formation and progression after each vaccination

Keloids are scars that extend beyond the original wound boundaries. They typically occur in darker skinned individuals with a familial tendency. Keloid formation has occurred after vaccination with bacilli Calmette-Guerin (BCG), small pox and hepatitis B vaccinations. We report the case of a 45-year-old female patient who developed extensive keloidal scars on her bilateral upper arms beginning in childhood after routine vaccinations. These keloids progressed with additional vaccines given at the same sites. Keloidal scars develop in anatomic areas exposed to increased skin tension as was seen in this patient. Treatment of these keloids is difficult but typically involves surgical excision, cryotherapy, radiation and intralesional and topical corticosteroids.