Sex Differences in Keloidogenesis: An Analysis of 1659 Keloid Patients in Japan

Dermatol Ther (Heidelb)

2021

Self Cite

Previous approaches to acne management have focused on the four main factors implicated in acne, namely, androgen-mediated sebogenesis (considered integral to acne), hyperkeratinization, colonization with Cutibacterium acnes, and inflammation related to both innate and adaptive mechanisms. Recent advances have facilitated potential novel approaches to acne management, as the pathophysiology and the immunological aspects related to acne and wound healing have evolved. Particular targets that have been shown to be closely involved in acne pathophysiology and wound healing include interleukin (IL)-1b, IL-17, IL-23, and tumor necrosis factor alpha (TNFa). Biological antibodies targeting IL-1b, IL-17, IL-23, and TNFa could provide novel approaches for treating severe acne and related disorders. Acne

Section: Pathophysiological Targets For Acne Treatmentmentioning

confidence: 99%

Updated Treatment for Acne: Targeted Therapy Based on Pathogenesis

Kurokawa

Layton

Dermatol Ther (Heidelb)

2021

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“…Systemic factors include the female hormone estrogen 31 : a large cross-sectional study showed that keloids may predominate in women. 32 Moreover, estrogen-induced vasodilation could worsen wound and scar inflammation: indeed, hypertrophic scars and keloids worsen during pregnancy 33 , 34 and improve after delivery. Another systemic factor is hypertension, which may aggravate hypertrophic scars and keloids.…”

Section: Prevention Of Postsurgical Hypertrophic Scars and Keloidsmentioning

confidence: 99%

The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids: A 2020 Update of the Algorithms Published 10 Years Ago

Plastic &Amp; Reconstructive Surgery

2021

Self Cite

127

Background: In 2010, this Journal published my comprehensive review of the literature on hypertrophic scars and keloids. In that article, I presented evidence-based algorithms for the prevention and treatment of these refractory pathologic scars. In the ensuing decade, substantial progress has been made in the field, including many new randomized controlled trials. To reflect this, I have updated my review. Methods: All studies were evaluated for methodologic quality. Baseline characteristics of patients were extracted along with the interventions and their outcomes. Systematic reviews, meta-analyses, and comprehensive reviews were included if available. Results: Risk factors that promote hypertrophic scar and keloid growth include local factors (tension on the wound/scar), systemic factors (e.g., hypertension), genetic factors (e.g., single-nucleotide polymorphisms), and lifestyle factors. Treatment of hypertrophic scars depends on scar contracture severity: if severe, surgery is the first choice. If not, conservative therapies are indicated. Keloid treatment depends on whether they are small and single or large and multiple. Small and single keloids can be treated radically by surgery with adjuvant therapy (e.g., radiotherapy) or multimodal conservative therapy. For large and multiple keloids, volume- and number-reducing surgery is a choice. Regardless of the treatment(s), patients should be followed up over the long term. Conservative therapies, including gel sheets, tape fixation, topical and injected external agents, oral agents, and makeup therapy, should be administered on a case-by-case basis. Conclusions: Randomized controlled trials on pathologic scar management have increased markedly over the past decade. Although these studies suffer from various limitations, they have greatly improved hypertrophic scar and keloid management. Future high-quality trials are likely to improve the current hypertrophic scar and keloid treatment algorithms further.

“…In addition, although boys and girls are equally likely to be vaccinated on their upper arm (a known cause of shoulder keloids), the female subcohort in the study was significantly more likely than the male subcohort to have upper-arm keloids. 49 However, large-scale cohort studies with long and complete follow-up are needed to confirm whether keloidogenesis does, indeed, associate with a physiologically based female predominance.…”

mentioning

confidence: 99%

Systemic factors that shape cutaneous pathological scarring

Huang

2020

FASEB j.

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Cutaneous pathological scars are fibrotic lesions that grow continuously, invade the adjacent skin, and are erythematous, itchy, and painful. Their etiology remains unclear but may involve genetic, local mechanical, and systemic factors. Here, we will summarize the main systemic factors that shape cutaneous pathological scarring, especially keloid formation and aggravation. They include circulating cytokines, chemokines, growth factors, particular cell types, sex hormones, the systemic renin‐angiotensin system, and vitamin D, all of which directly shape the angiogenesis, inflammation, fibrosis, and remodeling in pathological scars. There are also several environmental factors that more indirectly influence pathological scar formation or progression, namely diet, smoking, psychological stress, and exercise. Notably, much of the evidence on these systemic factors focus on their effects on one pathological scar characteristic, namely their fibrosis. However, systemic factors probably also shape other pathological scar characteristics. We describe two new avenues of keloid research that may greatly improve our understanding of pathological scarring and the systemic factors that affect it. One is the multiple similarities between keloids and tumors; the other is the different stem‐cell populations in keloids. We expect this research will greatly aid the development of diagnostic biomarkers for cutaneous pathological scars and drugs/techniques/regimens that prevent, improve, or cure these scars.