This clinical comparison shows a side-by-side progression of an earlobe keloid before and after CO2 laser treatment, visualized using the Vectra H2 digital vascular filter system. The images are presented in a reddish-tinted digital mode to highlight superficial vascularity. In the 'before' image (left), a large, pedunculated (Type I Chang-Park classification) keloid mass is visible, originating from the inferior aspect of the earlobe. The mass is prominently raised, with an irregular, bumpy texture and high vascular density indicated by darker red pigmentation compared to surrounding skin. The 'after' image (right), taken at a 6-month follow-up, demonstrates significant clinical improvement. There is a substantial reduction in the lesion's volume and height, returning the earlobe to a more anatomical shape. The vascularity appears decreased, evidenced by the lighter, more uniform color intensity across the treated site. This comparison illustrates the efficacy of laser therapy for hypertrophic scarring in dark-skinned patients (phototypes III-VI) and the utility of 3D vascular imaging for monitoring treatment response.

Side-by-side comparison of 3D digital clinical images (Quantificare system) showing a patient with a prominent earlobe keloid before and immediately after CO2 laser treatment. In the 'before' image (left), a large, smooth, pedunculated keloid mass is visible, significantly distorting the natural anatomy of the right earlobe. The patient has a high Fitzpatrick skin phototype. In the 'after' image (right), the bulky keloid has been ablated, resulting in a dramatic reduction in lesion volume. The treatment site shows immediate post-operative changes, including a raw, slightly uneven surface texture with pinpoint bleeding and removal of the primary mass, restoring the approximate contour of the earlobe. The images illustrate the efficacy of CO2 laser ablation in treating hypertrophic and keloid scarring in dermatological practice, particularly for complex anatomical areas like the ear helix and lobe.

A multi-panel figure illustrating the workflow for adjuvant radiotherapy of an earlobe keloid following surgical excision. Image A is a clinical photograph showing the immediate post-operative state of the earlobe, featuring surgical sutures and medical tape for positioning, with a millimeter ruler included for precise dimensional measurement. Image B displays the simulation phase for radiotherapy, showing a bolus material applied over the surgical site to ensure optimal surface dose distribution. Image C is an axial Computed Tomography (CT) scan used for treatment planning. The CT shows transverse cross-sections of the cranium and orbits. Superimposed on the left earlobe region is a color-coded dose-volume histogram (DVH) representation, with red indicating the high-dose target area and yellow contours defining the radiation field boundaries, labeled 'Field 1'. This composite image demonstrates the integration of clinical surgery, simulation, and radiological planning in dermatology and radiation oncology.