Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood Vessels
Background:. Keloids are red‚ invasive scars that are driven by chronic inflammation in the reticular dermis. The role of blood vessels in keloid behavior remains poorly understood. In the present study with 32 keloid patients, we examined the hemodynamics of keloid tissue, the anatomy of the blood...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer
2022-06-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004374 |
| _version_ | 1811237130483007488 |
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| author | Shigeyoshi Eura, MD Junichi Nakao, MD Takeshi Iimura, MD, PhD Shizuko Ichinose, PhD Chiemi Kaku, MD Teruyuki Dohi, MD, PhD Satoshi Akaishi, MD, PhD Mamiko Tosa, MD, PhD Rei Ogawa, MD, PhD, FACS |
| author_facet | Shigeyoshi Eura, MD Junichi Nakao, MD Takeshi Iimura, MD, PhD Shizuko Ichinose, PhD Chiemi Kaku, MD Teruyuki Dohi, MD, PhD Satoshi Akaishi, MD, PhD Mamiko Tosa, MD, PhD Rei Ogawa, MD, PhD, FACS |
| author_sort | Shigeyoshi Eura, MD |
| collection | DOAJ |
| description | Background:. Keloids are red‚ invasive scars that are driven by chronic inflammation in the reticular dermis. The role of blood vessels in keloid behavior remains poorly understood. In the present study with 32 keloid patients, we examined the hemodynamics of keloid tissue, the anatomy of the blood vessels feeding and draining the keloids, and the vascular histology of keloids.
Methods:. Ten patients with large anterior chest keloids underwent near-infrared spectroscopy, which measured regional saturation of oxygen and total hemoglobin index in the keloid and surrounding skin. Another 10 patients with large chest keloids and three healthy volunteers underwent multidetector-low computed tomography. The extirpated chest keloids of 12 patients were subjected to histology with optical, CD31 immunohistochemical, and electron microscopy.
Results:. All keloids had a low regional saturation of oxygen and a high total hemoglobin index, which is indicative of blood congestion. Multidetector-low computed tomography revealed dilation of the arteries and veins that were respectively feeding and draining the keloid leading edge. Hematoxylin-eosin staining and CD31 immunohistochemisty revealed considerable neovascularization in the keloid leading edge but not in the center. Electron microscopy showed that the lumens of many vessels in the keloid center appeared to be occluded or narrowed.
Conclusions:. Keloids seem to be congested because of increased neovascularization and arterial inflow at the leading edge and blocked outflow due to vascular destruction in the center. The surrounding veins seem to expand in response to this congested state. Methods that improve the blood circulation in keloids may be effective therapies. |
| first_indexed | 2024-04-12T12:20:47Z |
| format | Article |
| id | doaj.art-2b37126cb1944ea887276ab3dad2b603 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-04-12T12:20:47Z |
| publishDate | 2022-06-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-2b37126cb1944ea887276ab3dad2b6032022-12-22T03:33:18ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742022-06-01106e437410.1097/GOX.0000000000004374202206000-00015Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood VesselsShigeyoshi Eura, MD0Junichi Nakao, MD1Takeshi Iimura, MD, PhD2Shizuko Ichinose, PhD3Chiemi Kaku, MD4Teruyuki Dohi, MD, PhD5Satoshi Akaishi, MD, PhD6Mamiko Tosa, MD, PhD7Rei Ogawa, MD, PhD, FACS8From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.From the Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital, Tokyo, Japan.Background:. Keloids are red‚ invasive scars that are driven by chronic inflammation in the reticular dermis. The role of blood vessels in keloid behavior remains poorly understood. In the present study with 32 keloid patients, we examined the hemodynamics of keloid tissue, the anatomy of the blood vessels feeding and draining the keloids, and the vascular histology of keloids. Methods:. Ten patients with large anterior chest keloids underwent near-infrared spectroscopy, which measured regional saturation of oxygen and total hemoglobin index in the keloid and surrounding skin. Another 10 patients with large chest keloids and three healthy volunteers underwent multidetector-low computed tomography. The extirpated chest keloids of 12 patients were subjected to histology with optical, CD31 immunohistochemical, and electron microscopy. Results:. All keloids had a low regional saturation of oxygen and a high total hemoglobin index, which is indicative of blood congestion. Multidetector-low computed tomography revealed dilation of the arteries and veins that were respectively feeding and draining the keloid leading edge. Hematoxylin-eosin staining and CD31 immunohistochemisty revealed considerable neovascularization in the keloid leading edge but not in the center. Electron microscopy showed that the lumens of many vessels in the keloid center appeared to be occluded or narrowed. Conclusions:. Keloids seem to be congested because of increased neovascularization and arterial inflow at the leading edge and blocked outflow due to vascular destruction in the center. The surrounding veins seem to expand in response to this congested state. Methods that improve the blood circulation in keloids may be effective therapies.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004374 |
| spellingShingle | Shigeyoshi Eura, MD Junichi Nakao, MD Takeshi Iimura, MD, PhD Shizuko Ichinose, PhD Chiemi Kaku, MD Teruyuki Dohi, MD, PhD Satoshi Akaishi, MD, PhD Mamiko Tosa, MD, PhD Rei Ogawa, MD, PhD, FACS Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood Vessels Plastic and Reconstructive Surgery, Global Open |
| title | Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood Vessels |
| title_full | Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood Vessels |
| title_fullStr | Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood Vessels |
| title_full_unstemmed | Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood Vessels |
| title_short | Hemodynamics and Vascular Histology of Keloid Tissues and Anatomy of Nearby Blood Vessels |
| title_sort | hemodynamics and vascular histology of keloid tissues and anatomy of nearby blood vessels |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000004374 |
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