Report Epidemiology and clinical features of keloids in Black Africans: a nested case–control study from Yaound  e, Cameroon Emmanuel A. Kouotou 1,2,3 , MD, Jobert R. Nansseu 4 , MD Edwige Omona Guissana 1,3 , MD, Coralie Reine Mendouga Menye 5 , MD, Fabrice Akpadjan 6 , MD, Thiemo M. Tounkara 7 , MD, Anne-Cecile Zoung-Kanyi Bissek 3 , MD and Elie Claude Ndjitoyap Ndam 3 , MD 1 Yaound e University Teaching Hospital, Yaound e, Cameroon, 2 Biyem-Assi District Hospital, Yaound e, Cameroon, 3 Department of Internal Medicine and Specialities, Faculty of Medicine and Biomedical Sciences of the University of Yaound e I, Yaound e, Cameroon, 4 Department of Public Health, Faculty of Medicine and Biomedical Sciences of the University of Yaound e I, Yaound e, Cameroon, 5 Department of Morphological Sciences and Pathological Anatomy, Faculty of Medicine and Biomedical Sciences of the University of Yaound e I, Yaound e, Cameroon, 6 Department of Dermatology and Venerology Unit, Faculty of Health Sciences of Cotonou, University of Abomey Calavi, Cotonou, Benin, and 7 Department of Dermatology and Venerology, Teaching Hospital of Conakry and Gamal Abdel Nasser University, Conakry, Republic of Guinea Correspondence Jobert R. Nansseu, MD Department of Public Health Faculty of Medicine and Biomedical Sciences of the University of Yaound eI PO Box 1364 Yaound e, Cameroon E-mail: jobertrichie_nansseu@yahoo.fr. Conflict of interest: The authors declare no competing interests with regard to this article. doi: 10.1111/ijd.14610 Abstract Background Keloids are a common presenting complaint in Black Africans but remain poorly documented in these populations. The aim of our study was to describe the epidemiological and clinical profiles of patients with keloids seen at dermatology outpatient consultations in Yaound e (Cameroon) and to determine driving factors of keloid occurrence. Methods This was a 1 : 2 case–control study conducted from February to May 2016 at the dermatology unit of five health facilities in Yaound e, Cameroon. Cases were patients with black skin and diagnosed with keloids while controls had no keloid scar, paired to cases according to age and sex. The diagnosis of keloid was based on clinical history and findings. Results Of 2,940 patients seen during the study period, 102 (54.9% females) had keloids, hence a prevalence of 3.5% (95% confidence interval [CI]: 2.8–4.2). The most affected age group was ≥25 years (69.6%). Lesions at the origin of keloids were mostly traumatic (66.7%). In 68 patients (66.7%), keloid scars were associated with pruritus. The presternal region was the predominant localization (26.5%). Existence of a family history of keloids was significantly associated with presence of keloids (adjusted odds ratio: 4.2, 95% CI: 2.4–7.2; P < 0.001). Conclusions Keloids commonly affect black skin as recorded during dermatology consultations in Yaound e, Cameroon. More often, they are secondary to skin trauma and seem to occur among those with a family history of keloids. Therefore, these people should be closely monitored accordingly. Introduction The skin plays a major role in interactions with others: it con- tributes to seduction, especially when well-maintained. It reveals and betrays our emotions but is sometimes constrained to bear indelible scars resulting from multiple attacks by both exoge- nous and endogenous agents throughout our lives. Sometimes the healing process occurs abnormally, often leading to chronic wounds, retractile scars, and/or keloids. 1 Keloids are intradermal proliferations of the cutaneous con- nective tissue, secondary to an abnormal skin repair process with accumulation of collagen. 2 In sub-Saharan Africa, the fre- quency of ritual practices of scarification, tattooing, and piercing coupled with the predisposition of the black skin to develop this ª 2019 The International Society of Dermatology International Journal of Dermatology 2019 1