Keloids and Hypertrophic Scars

Wb, Rockwell; Ik, Cohen; Hp, Ehrlich

doi:10.1097/00006534-198911000-00021

Cited by 408 publications

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“…Keloids are proliferative dermal growths that represent a pathological wound healing response to skin injury by excessive deposition of collagens in the dermis and subcutaneous tissue [1][2][3][4]. Clinically, they are defined as scars that extend beyond the margins of the original wound, typically causing disfigurement, pruritus, pain, and contractures [1,2].…”

Section: Introductionmentioning

confidence: 99%

“…Clinically, they are defined as scars that extend beyond the margins of the original wound, typically causing disfigurement, pruritus, pain, and contractures [1,2]. The treatment strategies of keloids that include intralesional steroids, cryosurgery, radiotherapy, pressure therapy, 5-fluorouracil, silicone gel sheeting, and excisional surgery continue to be used and debated [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Suppressed TGF-?1 expression is correlated with up-regulation of matrix metalloproteinase-13 in keloid regression after flashlamp pulsed-dye laser treatment

Kuo

Jeng

et al. 2005

Lasers Surg. Med.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Suppressed TGF-?1 expression is correlated with up-regulation of matrix metalloproteinase-13 in keloid regression after flashlamp pulsed-dye laser treatment

Kuo

Jeng

et al. 2005

Lasers Surg. Med.

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“…Keloids are fibroproliferative scars that affect only humans (1,2). As opposed to hypertrophic scarring, which might result from transient exuberant remodeling of scar collagen and the extracellular matrix (ECM) 1 in response to skin stress and strain (3), keloids result from a pathological wound healing response.…”

mentioning

confidence: 99%

“…As opposed to hypertrophic scarring, which might result from transient exuberant remodeling of scar collagen and the extracellular matrix (ECM) 1 in response to skin stress and strain (3), keloids result from a pathological wound healing response. The keloid scar is well known clinically for its unique semiautonomous nature, with lesions that "overflow" the original wound margins and recur after excision.…”

mentioning

confidence: 99%

Synchronous Activation of ERK and Phosphatidylinositol 3-Kinase Pathways Is Required for Collagen and Extracellular Matrix Production in Keloids

Lim

Phan

Tan

et al. 2003

Journal of Biological Chemistry

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Keloid fibroproliferation appears to be influenced by epithelial-mesenchymal interactions between keloid keratinocytes (KKs) and keloid fibroblasts (KFs). Keloid and normal fibroblasts exhibit accelerated proliferation and collagen I and III production in co-culture with KKs compared with single cell culture or co-culture with normal keratinocytes. ERK and phosphatidylinositol 3-kinase (PI3K) pathway activation has been observed in excessively proliferating KFs in co-culture with KKs. We hypothesized that ERK and PI3K pathways might be involved in collagen and extracellular matrix production in KFs. To test our hypothesis, four samples of KFs were co-cultured in defined serum-free medium with KKs for 2-5 days. KF cell lysate was subjected to Western blot analysis. Compared with KF single cell culture, phospho-ERK1/2 and downstream phospho-Elk-1 showed up-regulation in the co-culture groups, as did phospho-PI3K and phospho-Akt-1, indicating ERK and PI3K pathway activation. Western blotting of the conditioned medium demonstrated increased collagen I-III, laminin ␤2, and fibronectin levels. Addition of the MEK1/2-specific inhibitor U0126 or the PI3K-specific inhibitor LY294002 (but not p38 kinase and JNK inhibitors) completely nullified collagen I-III production and significantly decreased laminin ␤2 and fibronectin secretion. In the presence of the MEK1/2 or PI3K inhibitor, fibronectin demonstrated changes in molecular mass reflected by faster in-gel migration. These data strongly suggest that synchronous activation of both the ERK and PI3K pathways is essential for collagen I-III and laminin ␤2 production. These pathways additionally appear to affect the side chain attachments of fibronectin. Modulation of these pathways may suggest a direction for keloid therapy.

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“…Keloids have the potential to be complicated by pruritus, tenderness, burning, secondary infection, ulceration and restriction of motion. 4,5 The penis is frequently subjected to surgical trauma, such as circumcision, but keloid formation is not a common complication or occurrence. Although keloid formation has been documented to be most frequent in patients between the ages of 15 and 45 years old, 6 our patient presented with a penile shaft keloid at the age of 19 months.…”

Section: Case Reportmentioning

confidence: 99%

Management of pediatric penile keloid

Yong

Afshar

MacNeily

et al. 2013

CUAJ

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Keloids are abnormal scar tissue growths that extend beyond the original area of injury, occasionally occurring post-surgery. Risk factors for keloids include skin trauma, infection, prolonged wound healing and individuals of certain ethnicities. Keloid formation on the penis, however, is a rare occurrence even among circumcised males, and can produce both aesthetic and functional complications. We document the tenth patient in the literature, to our knowledge, to present with a keloid of the penis. IntroductionKeloids are abnormal scar tissue growths that extend beyond the original area of injury, occasionally occurring post-surgery. Risk factors for keloids include skin trauma, infection and prolonged wound healing. Keloid formation on the penis, however, is a rare occurrence even among circumcised males, and can produce both aesthetic and functional complications. We document the tenth patient in the literature, to our knowledge, to present with a keloid of the penis. Case reportA 19-month-old male of African descent was referred to us with a keloid of the shaft of the penis. The patient had undergone a circumcision in the neonatal period and had since developed a thickened tumour. The patient's mother describes wound separation post-circumcision, with several weeks before ultimate healing. The patient was asymptomatic from a urologic point of view, but the lesion was not aesthetically acceptable to the family. The patient, of African descent, had no previous or family history of keloid formation. Given the extreme size of the tumour (Fig. 1, Fig. 2) and to prevent future complications, we decided to excise the keloid and reconstruct this either with a skin graft or via advancement of the local tissues.An incision was established with a 1-mm margin around the tumour through skin to the level of the dartos fascia. The keloid, measuring 4.6 cm × 1.8 cm, was dissected off of the dartos fascia circumferentially, and then excised in its entirety and sent to pathology for further histopathological review (Fig. 3, Fig. 4). The dartos fascia was not breached nor was the urethra entered.For reconstruction, a small lip of normal tissue was left at the ventral base of the corona resembling a circumcisionstyle incision. Proximally, for about 2cm circumferentially, the level of dartos fascial layer was undermined for tensionfree advancement of the penile shaft skin. The proximal tissues were able to be advanced to the corona without any evidence of tension. As such, reconstruction and closure of the skin followed. Monocryl 5-0 interrupted and running intracuticular sutures were used to close the wound (Fig. 5). There were no intraoperative complications and dressings consisted of bacitracin ointment only. The patient was discharged on postoperative day 1. The patient was recurrence-free 3 years postoperatively (Fig. 6). The patient had no postoperative complications related to urologic function. The histopathology was suggestive of a keloid and no other abnormalities were found upon analysis. DiscussionKeloids are...

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Keloids and Hypertrophic Scars

Cited by 408 publications

References 0 publications

Suppressed TGF-?1 expression is correlated with up-regulation of matrix metalloproteinase-13 in keloid regression after flashlamp pulsed-dye laser treatment

Suppressed TGF-?1 expression is correlated with up-regulation of matrix metalloproteinase-13 in keloid regression after flashlamp pulsed-dye laser treatment

Synchronous Activation of ERK and Phosphatidylinositol 3-Kinase Pathways Is Required for Collagen and Extracellular Matrix Production in Keloids

Management of pediatric penile keloid

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