Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis
<p>This 24-year-old female had a minor acne keloid on her chest that was treated by surgery, namely, total excision and z-plasty, plus postoperative taping fixation. Since the keloid was small, it could be removed totally and the tension was released by the z-plasty. Immediately after removing the sutures on day 10, silicone tape fixation was started to stabilize the wound. Eighteen months after surgery, recurrence was not observed. (<b>a</b>) Preoperative view; (<b>b</b>) design of the z-plasty; (<b>c</b>) immediately after surgery; and (<b>d</b>) 18 months after the operation.</p> "> Figure 2
<p>This 51-year-old female had a minor chest wall keloid that was treated by high-dose-rate superficial brachytherapy. A total of 25 Gy was administered in five fractions over 5 days. The inflammation resolved completely. After 1 year of treatment, both the subjective and objective symptoms had improved dramatically. (<b>a</b>) Pretreatment view; (<b>b</b>) 6 months post-treatment; and (<b>c</b>) 4 years post-treatment.</p> "> Figure 3
<p>This 75-year-old female had a mild right scapular keloid that was treated by deprodone propionate tape (Eclar<sup>®</sup> plaster). The tape was placed on the keloid 24 h a day and was changed daily. The inflammation resolved completely. After 19 months of treatment, both the subjective and objective symptoms of the patient had improved dramatically. (<b>a</b>) Pretreatment view; and (<b>b</b>) after 19 months of treatment.</p> "> Figure 4
<p>This 60-year-old female had a mild keloid that was treated by 1064 nm long-pulsed Nd:YAG laser. Long-pulsed 1064 nm Nd:YAG laser was used at the following settings: 5 mm spot diameter, 75 J/cm<sup>2</sup>, 25 msec, and 2 Hz. After 1 year of treatment, the scar had almost disappeared. The known target of long-pulsed Nd:YAG lasers is the blood vessels. Thus, we speculate that laser therapy largely treats pathological scars by decreasing blood vessel numbers, thereby inhibiting the inflammatory signals coming from the blood vessels. (<b>a</b>) Pretreatment view; (<b>b</b>) after 10 months of treatment; and (<b>c</b>) after 16 months of treatment.</p> ">
Abstract
:1. Introduction
2. Local Risk Factors That Increase Dermal Inflammation
3. Systemic Risk Factors That Increase Dermal Inflammation
4. Genetic Risk Factors That Increase Dermal Inflammation
5. Histopathology and Genetic Analysis of Keloid Tissue
6. Treatment of Keloids and Hypertrophic Scars
6.1. Surgery
6.2. Radiotherapy
6.3. Corticosteroid Administration
6.4. Compression Therapy
6.5. Stabilization Therapy
6.6. Laser Therapy
6.7. 5-FU Therapy
6.8. Cryotherapy
6.9. Other Therapies
7. Conclusions
Conflicts of Interest
References
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Ogawa, R. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. Int. J. Mol. Sci. 2017, 18, 606. https://doi.org/10.3390/ijms18030606
Ogawa R. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. International Journal of Molecular Sciences. 2017; 18(3):606. https://doi.org/10.3390/ijms18030606
Chicago/Turabian StyleOgawa, Rei. 2017. "Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis" International Journal of Molecular Sciences 18, no. 3: 606. https://doi.org/10.3390/ijms18030606