A 67-year-old male presented with early hypertrophic and keloid scarring 4 months after undergoing a skin graft 

for a chemical burn sustained 5 months prior. The graft site, located on the lateral aspect of the foot and ankle, 

exhibited raised, darkly pigmented keloid tissue with irregular texture, surface scaling, and prominent nodular borders. 

The patient experienced severe pruritus, persistent pain, and difficulty walking due to tissue tightness and 

contracture at the ankle joint.

Total treatment time was 18 month

•  The pigmentation of the scar significantly normalized. The previously dark violaceous and   

                   reddish discoloration diminished, blending more seamlessly with the surrounding skin.

                      •  There was a marked reduction in scar thickness and protrusion. The previously elevated, nodular               

                          keloidal margins flattened considerably, resulting in a more even surface contour.

                      •  The texture of the skin improved noticeably. The rough, scaly, and irregular surface observed    

                          before treatment became smoother, with improved elasticity and a healthy sheen.

                      •  Subjective symptoms, including persistent itching and pain, were fully relieved. 

                          The patient reported no discomfort during rest or ambulation following treatment.

                •   Functional recovery was also observed. The initial gait disturbance caused by contracture and 

                   scar tightness around the ankle was resolved.

The patient regained the ability to walk unaided, indicating a significant improvement 

in mobility and joint flexibility.

                                 When keloid formation accompanies the early stage of skin graft healing, the treatment

                                  becomes significantly more complex. The symptoms and scar thickness tend to fluctuate, 

                                   alternating between improvement and worsening. However, with careful and experienced 

                                    clinical judgment, timely interventions have been made, allowing the patient to recover 

                                   steadily without complications. Pre- and post-treatment images are displayed in figure.