Hypertrophic scars and keloids: a review and current treatment modalities

Tripathi, Shweta; Soni, Kumud; Agrawal, Poornima; Gour, Vishal; Mondal, Rajesh; Soni, Vandana

doi:10.1186/s41702-020-00063-8

Cited by 31 publications

(32 citation statements)

References 54 publications

(65 reference statements)

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“…AD and keloid share common inflammatory pathways that are characterized by T-helper cell 2 (Th2) cytokines. An impaired inflammatory response of fibrogenesis involving Th2 cytokines secreted by CD4 + T cells such as interleukin (IL)-4, IL-5, IL-10, and IL-13, leads to the imbalance between pro-fibrotic and anti-fibrotic signals 7 . Additionally, in AD, upregulation of Th2 cytokines is triggered, and IL-4, IL-5, IL-10, and IL-13 are secreted, resulting in epidermal thickening, inflammation, pruritus, and decreased expression of barrier proteins such as filaggrin and loricrin, all of which are clinical characteristics of AD 8 .…”

Section: Introductionmentioning

confidence: 99%

The increased prevalence of keloids in atopic dermatitis patients with allergic comorbidities: a nationwide retrospective cohort study

Kwon

Ahn

Jeong

et al. 2021

Sci Rep

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Atopic dermatitis (AD) is associated with allergic comorbidities, such as asthma, allergic rhinitis (AR), and allergic contact dermatitis (ACD). The etiology of keloid is largely unknown; however, AD and keloid share inflammatory pathways characterized by T-helper cell 2 cytokines and increased dermal fibroblast activity. The prevalence of keloids has been reported to increase in patients with AD, but it remains controversial. This study aimed to estimate the prevalence of keloids in patients with AD, and compare it with the prevalence of other comorbidities of AD. We assessed the Korean National Health Information Database and medical records including coexisting asthma, AR, and ACD. Single and multiple logistic regression models were created for keloids and each allergic disease. The prevalence of keloids was higher in the AD group than in the control group. Among patients with AD, adolescents and adults had a higher prevalence of keloids than infants and children. The risk of keloids was high with AD alone, and coexisting asthma significantly increased the risk. Similarly, the risk of keloids was higher in AR associated with AD and ACD associated with AD than in AD alone. Thus, among Koreans, patients with AD have a higher risk of keloid development, with coexisting allergic diseases increasing the risk.

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Section: Introductionmentioning

confidence: 99%

The increased prevalence of keloids in atopic dermatitis patients with allergic comorbidities: a nationwide retrospective cohort study

Kwon

Ahn

Jeong

et al. 2021

Sci Rep

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“…They execute and modulate a complex signaling network and when altered, could lead to hypervascularity and excessive (pathological) deposition of ECM components. Fibroblasts and myofibroblasts are the main cell types involved in scar pathogenesis 30,32 . However, other cells, such as keratinocytes and mast cells, actively participate in the progression or regression of scars, resulting in the production of massive amounts of collagen, which favours the accumulation of ECM below the dermis, leading to scar formation [32][33][34] .…”

Section: The Complexity Of the Wound Healing Processmentioning

confidence: 99%

Wound dressings as growth factor delivery platforms for chronic wound healing

Catanzano

Quaglia

Boateng

2021

Expert Opinion on Drug Delivery

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Introduction: Years of tissue engineering research have clearly demonstrated the potential of integrating growth factors (GFs) into scaffolds for tissue regeneration, a concept that has recently been applied to wound dressings. The old concept of wound dressings that only take a passive role in wound healing has now been overtaken, and advanced dressings which can take an active part in wound healing, are of current research interest. Areas covered:In this review we will focus on the recent strategies for the delivery of GFs to wound sites with an emphasis on the different approaches used to achieve fine tuning over spatial and temporal concentrations to achieve therapeutic efficacy.Expert Opinion: The use of GFs to accelerate wound healing and reduce scar formation is now considered a feasible therapeutic approach in patients with a high risk of infections and complications. The integration of micro-and nanotechnologies into wound dressings could be the key to overcome the inherent instability of GFs and offer adequate control over the release rate. Many investigations have led to encouraging outcomes in various in vitro and in vivo wound models, and it is expected that some of these technologies will satisfy clinical needs and will enter commercialization.

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“…Since then, multiple therapeutic options have been used in pursuit of the goal of optimal scar improvement with varying degrees of success 4,5 . Over time, the proper formula for optimal scar treatment has been increasingly outlined including the realization that wound healing and scar treatment are not separate endeavors 6 .…”

Section: Background Hypertrophic Scars and Keloidsmentioning

confidence: 99%

Treatment approaches for treating hypertrophic scars and keloids

Gianatasio

Abrouk

Waibel

2021

Dermatological Reviews

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Background and Purpose Hypertrophic and keloid scars can have a dramatic impact on the quality of life for patients. Their complexity and multimodal nature also present significant challenges to physicians. Each scar presentation is unique due to influences such as the source of injury and specific healing properties of the patient. As such, each treatment must be equally individual. The goal of this study is to provide the tools to navigate complex hypertrophic and keloid scar treatment by outlining treatment algorithms that can be tailored to each specific presentation. Methods The authors combined a review of rising clinical research and consensus papers with lessons drawn from clinical practice to create comprehensive treatment recommendations. Results A wide variety of treatment options were incorporated into the algorithms which were drawn from world scar expert consensus including moisturization/compression, surgery, laser therapy, and laser‐assisted drug delivery. Scars of all ages were included and should be treated, though age should factor into treatment intensity. Particularly with hypertrophic and keloid scars, location and resulting tension is a primary consideration in treatment strategy. In keloid scars, radiation therapy can also play a role. Conclusion The authors propose that a combination treatment strategy customized to scar type, depth, texture, and dyschromia is necessary to produce optimal results. Early intervention is preferable though not essential to achieve scar mitigation. With careful and appropriate treatment algorithms, patients with debilitating scarring may recover significant function, cosmesis, and overall quality of life.

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Hypertrophic scars and keloids: a review and current treatment modalities

Cited by 31 publications

References 54 publications

The increased prevalence of keloids in atopic dermatitis patients with allergic comorbidities: a nationwide retrospective cohort study

The increased prevalence of keloids in atopic dermatitis patients with allergic comorbidities: a nationwide retrospective cohort study

Wound dressings as growth factor delivery platforms for chronic wound healing

Treatment approaches for treating hypertrophic scars and keloids

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