Multifocal auricular keloids following piercing: clinical presentation, contributing factors, and therapeutic considerations in a young adult

Antonella Tammaro; Dario Cerqua; Elena Gaetano; ilaria Demofonte; Gabriella De Marco; Stefano Dastoli

doi:10.57662/am.2026.18536

Multifocal auricular keloids following piercing: clinical presentation, contributing factors, and therapeutic considerations in a young adult

Authors

Antonella Tammaro Department of Dermatology, Università Magna Graecia Catanzaro, Catanzaro, Italy
Dario Cerqua Department of Dermatology, Università Magna Graecia Catanzaro, Catanzaro, Italy
Elena Gaetano Department of Dermatology, Università Magna Graecia Catanzaro, Catanzaro, Italy
ilaria Demofonte Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Gabriella De Marco Unit of Dermatology, Department of Internal Medicine and Medical Specialties, Sapienza University, Rome, Italy
Stefano Dastoli Department of Dermatology, Università Magna Graecia Catanzaro, Catanzaro, Italy

Keywords:

Auricular keloids, Piercing-related scarring, Multifocal lesions, Contact dermatitis, Keloid management, Multimodal therapy

Abstract

Introduction: Keloids are fibroproliferative scars arising from aberrant wound healing, with auricular sites being particularly susceptible after piercings.

Objectives: To report the case of a young woman who developed multiple auricular keloids following piercings and to highlight the factors contributing to their progression.

Methods: A 19-year-old woman with six keloid lesions on both ears following multiple piercings was clinically evaluated. The characteristics of the lesions and associated cutaneous findings were assessed.

Results: The largest lesions were firm, sessile, and clinically stable, while newer formations showed mild inflammation. Crusted, desquamative areas on the earlobes suggested concomitant allergic contact dermatitis to nickel sulfate. Persistent use of piercings after the onset of early lesions likely contributed to further keloid development, particularly on the right antihelix.

Conclusions: This case highlights the role of mechanical and inflammatory triggers in keloid progression and underscores the importance of early recognition, removal of precipitating factors, and consideration of multimodal therapy to prevent recurrence.

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