Keloids and Hypertrophic Scars: Update and Future Directions
Summary: The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “a...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2013-07-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/Fulltext/2013/07000/Article.5.aspx |
| _version_ | 1818559753188540416 |
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| author | Chenyu Huang, MD, PhD George F. Murphy, MD, PhD Satoshi Akaishi, MD, PhD Rei Ogawa, MD, PhD, FACS |
| author_facet | Chenyu Huang, MD, PhD George F. Murphy, MD, PhD Satoshi Akaishi, MD, PhD Rei Ogawa, MD, PhD, FACS |
| author_sort | Chenyu Huang, MD, PhD |
| collection | DOAJ |
| description | Summary: The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “aberrant wound healing” or that they are “characterized by hyalinized collagen bundles” have done little to promote their accurate clinicopathological classification or to stimulate research into the specific causes of these scars and effective preventative therapies. To overcome this barrier, we review here the most recent findings regarding the pathology and pathogenesis of keloids and HSs. The aberrations of HSs and keloids in terms of the inflammation, proliferation, and remodeling phases of the wound healing process are described. In particular, the significant roles that the extracellular matrix and the epidermal and dermal layers of skin play in scar pathogenesis are examined. Finally, the current hypotheses of pathological scar etiology that should be tested by basic and clinical investigators are detailed. Therapies that have been found to be effective are described, including several that evolved directly from the aforementioned etiology hypotheses. A better understanding of pathological scar etiology and manifestations will improve the clinical and histopathological classification and treatment of these important lesions. |
| first_indexed | 2024-12-14T00:29:37Z |
| format | Article |
| id | doaj.art-1a15e5b1c7f64d5d89e9bd95b77378f3 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-14T00:29:37Z |
| publishDate | 2013-07-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-1a15e5b1c7f64d5d89e9bd95b77378f32022-12-21T23:24:53ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742013-07-0114e2510.1097/GOX.0b013e31829c459701720096-201307000-00005Keloids and Hypertrophic Scars: Update and Future DirectionsChenyu Huang, MD, PhD0George F. Murphy, MD, PhD1Satoshi Akaishi, MD, PhD2Rei Ogawa, MD, PhD, FACS3From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, Tokyo, JapanProgram in Dermatopathology, Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.;From the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, Tokyo, JapanFrom the Department of Plastic, Reconstructive, and Aesthetic Surgery, Nippon Medical School, Tokyo, JapanSummary: The development of cutaneous pathological scars, namely, hypertrophic scars (HSs) and keloids, involves complex pathways, and the exact mechanisms by which they are initiated, evolved, and regulated remain to be fully elucidated. The generally held concepts that keloids and HSs represent “aberrant wound healing” or that they are “characterized by hyalinized collagen bundles” have done little to promote their accurate clinicopathological classification or to stimulate research into the specific causes of these scars and effective preventative therapies. To overcome this barrier, we review here the most recent findings regarding the pathology and pathogenesis of keloids and HSs. The aberrations of HSs and keloids in terms of the inflammation, proliferation, and remodeling phases of the wound healing process are described. In particular, the significant roles that the extracellular matrix and the epidermal and dermal layers of skin play in scar pathogenesis are examined. Finally, the current hypotheses of pathological scar etiology that should be tested by basic and clinical investigators are detailed. Therapies that have been found to be effective are described, including several that evolved directly from the aforementioned etiology hypotheses. A better understanding of pathological scar etiology and manifestations will improve the clinical and histopathological classification and treatment of these important lesions.http://journals.lww.com/prsgo/Fulltext/2013/07000/Article.5.aspx |
| spellingShingle | Chenyu Huang, MD, PhD George F. Murphy, MD, PhD Satoshi Akaishi, MD, PhD Rei Ogawa, MD, PhD, FACS Keloids and Hypertrophic Scars: Update and Future Directions Plastic and Reconstructive Surgery, Global Open |
| title | Keloids and Hypertrophic Scars: Update and Future Directions |
| title_full | Keloids and Hypertrophic Scars: Update and Future Directions |
| title_fullStr | Keloids and Hypertrophic Scars: Update and Future Directions |
| title_full_unstemmed | Keloids and Hypertrophic Scars: Update and Future Directions |
| title_short | Keloids and Hypertrophic Scars: Update and Future Directions |
| title_sort | keloids and hypertrophic scars update and future directions |
| url | http://journals.lww.com/prsgo/Fulltext/2013/07000/Article.5.aspx |
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