Keloids: the natural history.

There is abundant evidence in the literature that keloids and hypertrophic scars are different stages of the same process. The evidence, clinical and histogenetic, also shows that the hypertrophic scar is the earlier of the two stages. It therefore follows that all keloids do evolve through the hypertrophic scar phase. These conclusions have largely eased the confusion of nomenclature and made a clinicopathologic correlation of the available knowledge on keloid possible.