Keloid associated with hypertension

Snyder, Alyson; Zmuda, JosephM.; Thompson, P D

doi:10.1016/s0140-6736(96)90042-2

Cited by 13 publications

(6 citation statements)

References 5 publications

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“…To date there have been few large-scale association studies for excessive scarring. [10][11][12][13]15 This cross-sectional study aimed to both validate previously studied associations (hypertension, 16,34,35 uterine leiomyoma, 13,17 vitamin D deficiency, 14,15 and atopic eczema 11,12 ) as well as scan for excessive scarring associations across the phenome. Our ethnicity-specific analysis includes a comprehensive study in White people, the most-represented ethnic group in UKB, and an understudied group in keloid literature.…”

Section: Discussionmentioning

confidence: 99%

Comorbidities of Keloid and Hypertrophic Scars Among Participants in UK Biobank

et al. 2023

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ImportanceKeloids and hypertrophic scars (excessive scarring) are relatively understudied disfiguring chronic skin conditions with high treatment resistance.ObjectiveTo evaluate established comorbidities of excessive scarring in European individuals, with comparisons across ethnic groups, and to identify novel comorbidities via a phenome-wide association study (PheWAS).Design, Setting, and ParticipantsThis multicenter cross-sectional population-based cohort study used UK Biobank (UKB) data and fitted logistic regression models for testing associations between excessive scarring and a variety of outcomes, including previously studied comorbidities and 1518 systematically defined disease categories. Additional modeling was performed within subgroups of participants defined by self-reported ethnicity (as defined in UK Biobank). Of 502 701 UKB participants, analyses were restricted to 230078 individuals with linked primary care records.ExposuresKeloid or hypertrophic scar diagnoses.Main Outcomes and MeasuresPreviously studied disease associations (hypertension, uterine leiomyoma, vitamin D deficiency, atopic eczema) and phenotypes defined in the PheWAS Catalog.ResultsOf the 972 people with excessive scarring, there was a higher proportion of female participants compared with the 229 106 controls (65% vs 55%) and a lower proportion of White ethnicity (86% vs 95%); mean (SD) age of the total cohort was 64 (8) years. Associations were identified with hypertension and atopic eczema in models accounting for age, sex, and ethnicity, and the association with atopic eczema (odds ratio [OR], 1.68; 95% CI, 1.36-2.07; P &lt; .001) remained statistically significant after accounting for additional potential confounders. Fully adjusted analyses within ethnic groups revealed associations with hypertension in Black participants (OR, 2.05; 95% CI, 1.13-3.72; P = .02) and with vitamin D deficiency in Asian participants (OR, 2.24; 95% CI, 1.26-3.97; P = .006). The association with uterine leiomyoma was borderline significant in Black women (OR, 1.93; 95% CI, 1.00-3.71; P = .05), whereas the association with atopic eczema was significant in White participants (OR, 1.68; 95% CI, 1.34-2.12; P &lt; .001) and showed a similar trend in Asian (OR, 2.17; 95% CI, 1.01-4.67; P = .048) and Black participants (OR, 1.89; 95% CI, 0.83-4.28; P = .13). The PheWAS identified 110 significant associations across disease systems; of the nondermatological, musculoskeletal disease and pain symptoms were prominent.Conclusions and RelevanceThis cross-sectional study validated comorbidities of excessive scarring in UKB with comprehensive coverage of health outcomes. It also documented additional phenome-wide associations that will serve as a reference for future studies to investigate common underlying pathophysiologic mechanisms.

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Section: Discussionmentioning

confidence: 99%

Comorbidities of Keloid and Hypertrophic Scars Among Participants in UK Biobank

et al. 2023

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“…Our lack of significance with hypertension differs from multiple published studies. [6][7][8] It is possible that pregnancy obfuscates the difference in rates of hypertension between those that keloid and those that do not.…”

Section: Discussionmentioning

confidence: 99%

“…1 Recent research suggests that keloid pathogenesis may be related to a variety of factors, including genetic, epigenetic, systemic, and local (such as mechanical tension). 3 There have been some studies showing keloids are associated with osteoporosis, 4 leiomyomas, 5 as well as hypertension and obesity, [6][7][8] but the number of studies is limited. Furthermore, these studies typically have not controlled for a uniform insult to the skin, such as those who have undergone major surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

A retrospective study on the association of keloids with underlying health conditions in African-American Women

Marella

Glass

2023

International Journal of Women’s Dermatology

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Background: Keloids are disfiguring benign scars that develop due to an exaggerated response to cutaneous wound healing, growing beyond the boundaries of the cutaneous insult into normal, previously uninvolved skin. The association of keloids with other underlying health conditions has been postulated, but not well characterized. Objective: This study aims to identify whether there is any association of keloids with underlying health conditions in African-American women. Methods: This study was done via the use of the National Inpatient Sample, a subset of the Healthcare Cost and Utilization Project. African-American women with keloids who had undergone cesarean sections were compared with a control group of African-American women with no history of keloids who had undergone cesarean sections. Results: A total of 301 African-American inpatient encounters with patients with keloids were compared with 37,144 encounters in the control group. The keloid patients had an increased association with peritoneal adhesions compared with the control group. Limitations: results are limited to one race and restricted age range; also, unable to differentiate keloids from hypetrophic scarring with ICD-10 codes. Conclusion: These findings suggest that keloids and peritoneal adhesions may have similar inflammatory processes.

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“…Hypertension has been linked to the susceptibility for the development of KD (3), with both occurring more frequently in individuals of African descent than Caucasians (67). Patients with KD are more likely to have concomitant hypertension than patients without KD (68). Improvement of KLs in hypertensive patients has been observed following treatment with anti-hypertensive medications, such as ACE inhibitors (66) and calcium channel blockers (69).…”

Section: Hypertension and Keloid Disordermentioning

confidence: 99%

The Role of the Renin-Angiotensin System and Vitamin D in Keloid Disorder—A Review

et al. 2019

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Keloid disorder (KD) is a fibroproliferative condition characterized by excessive dermal collagen deposition in response to wounding and/or inflammation of the skin. Despite intensive research, treatment for KD remains empirical and unsatisfactory. Activation of the renin-angiotensin system (RAS) leads to fibrosis in various organs through its direct effect and the resultant hypertension, and activation of the immune system. The observation of an increased incidence of KD in dark-skinned individuals who are predisposed to vitamin D deficiency (VDD) and hypertension, and the association of KD with hypertension and VDD, all of which are associated with an elevated activity of the RAS, provides clues to the pathogenesis of KD. There is increasing evidence implicating embryonic-like stem (ESC) cells that express ESC markers within keloid-associated lymphoid tissues (KALTs) in keloid lesions. These primitive cells express components of the RAS, cathepsins B, D, and G that constitute bypass loops of the RAS, and vitamin D receptor (VDR). This suggests that the RAS directly, and through signaling pathways that converge on the RAS, including VDR-mediated mechanisms and the immune system, may play a critical role in regulating the primitive population within the KALTs. This review discusses the role of the RAS, its relationship with hypertension, vitamin D, VDR, VDD, and the immune system that provide a microenvironmental niche in regulating the ESC-like cells within the KALTs. These ESC-like cells may be a novel therapeutic target for the treatment of this enigmatic and challenging condition, by modulating the RAS using inhibitors of the RAS and its bypass loops and convergent signaling pathways.

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Keloid associated with hypertension

Cited by 13 publications

References 5 publications

Comorbidities of Keloid and Hypertrophic Scars Among Participants in UK Biobank

Comorbidities of Keloid and Hypertrophic Scars Among Participants in UK Biobank

A retrospective study on the association of keloids with underlying health conditions in African-American Women

The Role of the Renin-Angiotensin System and Vitamin D in Keloid Disorder—A Review

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