Keloids and Hypertrophic Scars Signs and Symptoms

Cập nhật: 04 March 2025

Definition

  • Patch of fibrous tissue that replaces the normal skin tissue after wounds, trauma, burns, surgical incision or disease
  • Helps to close open wounds and prevent infection
  • Can be painful, pruritic and limit mobility

Yếu tố nguy cơ

  • Delay in wound healing due to certain types of trauma (eg burns, ear piercing)
  • Extent and duration of inflammation
  • Magnitude of mechanical tension acting on the scar
  • Acne, chickenpox, Bacille Calmette-Guérin (BCG) vaccinations, biopsy procedures and lacerations may cause abnormal scarring
  • Darkly pigmented skin due to the melanocyte-stimulating hormone anomalies
  • Genetic phenotype (familial predisposition) in keloids
  • Black, Hispanic and Asians have increased risk
    • Asian skin has a tendency to develop hyperpigmentation and scar formation after an injury
    • Asians have greater collagen density than Caucasians that manifests a tendency to a more vigorous fibroplastic response during wound healing that results in hypertrophic scarring and prolonged erythema during scar maturation
    • Asian skin also has increased melanin that leads to increased sebum secretion that is characterized by increased proliferation of fibroblast and more vigorous collagen formation and fibroplasia during wound healing
  • Increased prevalence in patients <30 years old (peak 10-20 years)
  • Common in patients with elevated hormone levels (eg during puberty or pregnancy)

Sinh lý bệnh

  • Skin wound healing process involves overlapping phases of inflammation, proliferation, and maturation or remodeling
    • In the inflammatory phase, hemostasis occurs, followed by an acute inflammatory platelet and white blood cell infiltration
    • Proliferation stage involves fibroplasia, granulation, contraction and epithelialization
    • Remodeling or scar maturation occurs when enough provisional tissue is generated and characterized by disorganized array of collagen and loss of dermal appendages