In the face and neck, keloid scar distribution is related to skin thickness and stiffness changes associated with movement.

Keloid scars tend to occur in high-tension sites due to mechanical stimuli that are involved in their development. To date, a detailed analysis of keloid distribution focused specifically on facial and neck areas has not been reported, and limited literature exists as to the related mechanical factors. To rectify this deficiency of knowledge, we first quantified the facial and neck keloid distribution observed clinically in 113 patients. Subsequently, we performed a rigorous investigation into the mechanical factors and their associated changes at these anatomic sites in healthy volunteers without a history of pathologic scarring. The association between keloid-predilection sites and sebaceous gland-dense and acne-prone sites was also examined. To assess skin stretch, thickness and stiffness, VECTRA, ultrasound and indentometer were utilised. Baseline skin stiffness and thickness were measured, as well as the magnitude of change in these values associated with facial expression and postural changes. Within the face and neck, keloids were most common near the mandibular angle (41.3%) and lateral submental (20.0%) regions. These areas of increased keloid incidence were not associated with areas more dense in sebaceous glands, nor linked consistently with acne-susceptible regions. Binomial logistic regression revealed that changes in skin stiffness and thickness related to postural changes significantly predicted keloid distribution. Skin stiffness and thickness changes related to prolonged mechanical forces (postural changes) are most pronounced at sites of high keloid predilection. This finding further elucidates the means by which skin stretch and tension are related to keloid development. As a more detailed analysis of mechanical forces on facial and neck skin, this study evaluates the nuances of multiple skin-mechanical properties, and their changes in a three-dimensional framework. Such factors may be critical to better understanding keloid progression and development in the face and neck.

Research advances on the influence of poor dietary habits on the development of keloids / 中华烧伤杂志

Long-term poor dietary habits can cause changes in the intestinal flora, resulting in the production of a large number of lipopolysaccharide, increase intestinal mucosal permeability, and activate the entrance of a large number of inflammatory factors into the portal vein. In addition, a high carbohydrate diet can increase liver metabolic burden, increase mitochondrial oxidative phosphorylation, leading to oxidative stress, generate new fat during adenosine triphosphate synthesis, and thus resulting in ectopic fat accumulation, which further activate nuclear factor-κB signaling pathway and release inflam- matory factors such as tumor necrosis factor-α, interleukin-1β (IL-1β), IL-6, and so on. This leads to obesity and insulin resis- tance, ultimately triggering systemic low-grade inflammation. This article reviews the mechanism of poor dietary habits leading to systemic low-grade inflammation, the clinical and experimental research progress of keloids and systemic low-grade inflammation, the association between dietary habits and keloid constitution, and puts forward the hypothesis that poor dietary habits may lead to the occurrence and development of keloids.

Actualización en el tratamiento y cuidado de las cicatrices / Update on the treatment and care of scars

Las cicatrices producidas por quemadura causan graves secuelas por limitaciones funcionales y estéticas, y llegan a tener importantes consecuencias psicológicas capaces de limitar las relaciones personales y sociales de los que las padecen. En este artículo se hace una revisión de los tipos de cicatrices, los factores que intervienen en su formación, sus características y una actualización de las distintas opciones de prevención y tratamientos de las cicatrices patológicas en el paciente quemado. El texto concluye con una exposición de técnicas de camuflaje de cicatrices mediante maquillaje (AU)

Scars due to burns cause important aesthetic and functional squeal, causing psicologic disorders that can limit personal and social relationships of these patients. In this article we review the type of scars, the factors influencing its function, its characteristics, and we update the different options to prevent and treat pathologic scars in these patients. The text concludes with an exhibition of camouflage techniques of scars through make-up (AU)

Queloides y cicatrices hipertróficas: problema frecuente de manejo complejo / Keloids and hypertrophic scars: frequent problem of complex management

Keloids and hypertrophic scars are frequent observed. These two conditions are considered part of the abnormal wound-healing spectrum. The main difference between keloids and hypertrophic scars is the scar extension in relation to the original incision, where former extends beyond the original incision while the latter respects it. The main issue with both conditions is that treatment modalities used today offer unacceptable high recurrence rates, between 50 to 70 percent, when they are applied as monotherapy. With combined treatment modalities recurrence rates have improved partially depending mainly in the chosen combination and so, this strategy is likely the optimal choice for the management of these lesions. The objective of this review was to highlight the pathophysiology, clinical features, and management of keloids with mono or combined therapy, focusing mainly in the surgical and radiotherapy/brachytherapy modalities.

Keloid Scarring: New Treatments Ahead / Queloides: Nuevos tratamientos en el Futuro

Keloid disease presents a healthcare challenge: patients suffer from pruritus, pain, inflammation, and cosmetic disfigurement. There is no single effective therapeutic regimen for keloids. Numerous treatment options have been described including occlusive dressings, compression therapy, intralesional steroid injections, laser and radiation therapy, cryosurgery, 5-fluorouracil, interferon, and imiquimod cream, but managing keloid disease still is a considerable problem for clinicians. Better understanding of the molecular mechanisms behind keloid disease led to the development of new promising therapies like the application of recombinant TGF-b3, interleukin 10, and imatinib mesylate. This review provides an overview of the existing therapeutic options for keloid disease and summarizes upcoming future therapies with a special focus on blocking the transforming growth factor-beta pathway (AU)

Los queloides representan un reto de atención sanitaria: los pacientes padecen prurito, dolor, inflamación y desfiguración cosmética. No existe ningún tratamiento efectivo para los queloides. Se han descrito numerosas opciones terapéuticas que incluyen vendajes oclusivos, terapia de compresión, corticoides intralesionales, láser, radioterapia, criocirugía, 5-fluorouracilo, interferón e imiquimod, pero el tratamiento continúa siendo un problema considerable para los clínicos. Se han desarrollado nuevas y prometedoras terapias, como la aplicación de TGF-b3 recombinante, interleuquina 10 y mesilato de imatinib gracias a un mayor conocimiento de los mecanismos moleculares responsables de los queloides. Esta revisión ofrece una visión de conjunto de las opciones terapéuticas disponibles para los queloides y resume las futuras terapias, haciendo especial énfasis en los bloqueadores de la vía del factor de crecimiento transformador beta (AU)

Cellular signaling in tissue regeneration

With recent progress in stem cell-based research, there has been tremendous interest in stem cell-based tissue regeneration. Stem cells can be differentiated into specialized cells/tissues by growth factors and cytokines. These small molecules are thought to play an important role in both wound healing and tissue regeneration. However, their biological activity and signal transduction during tissue regeneration are poorly understood. With recent advances in signal transduction by growth factors, the receptor kinases and G protein-coupled receptors, an understanding in the underlying mechanism of how these factors regulate tissue regeneration beginning to take place. In this review, the potential underlying mechanisms of growth factor signaling in normal tissue regeneration and chronic wound healing is discussed. Thus, it is an aim to provide a basis for designing more specific therapies for tissue regeneration in the near future.

The mast cell and trauma / 法医学杂志

Mast cell(MC) takes an important role in trauma and the process of wound healing, and the pathophysiology reaction has a relationship to the time since trauma, which is helpful to determine the post-trauma and postmortem interval, and to distinguish the wound shaped whether before or after death. In this paper, the role of MC and its chemic medium in the process of wound healing, scar shaping, postburns inflammatory response, healing of bone fracture, as well as the signification for forensic medicine and the progress of researching in this field were reviewed.

Queloide / Keloid

El queloide es un tipo de cicatrización de interés para la medicina general y particularmente para la cirugía. Este tipo de cicatrización es un fenómeno persistente, antiestético y algunas veces incapacitante; su manejo es difícil y el resultado con frecuencia es decepcionante para el paciente. Consideramos que toda información acerca de la cicatriz queloide nos hará entender mejor esta entidad. Abordamos los aspectos generales del queloide, incluyendo su historia, factores coadyuvantes, fisiopatología, aspectos clínicos, evolución, diagnóstico diferencial, histología y tratamiento.

Quelóide e cicatriz hipertrófica: fisiopatologia e conduta terapêutica / Keloid and hypertrophic cicatrix

Os autores apresentam uma revisão sobre a etiologia do quelóide e da cicatriz hipertrófica, bem como sobre as atuais alternativas de tratamento. Essas cicatrizes são resultado de um processo cicatricial alterado e apresentam-se frequentemente na prática clínica. Não existe atualmente um consenso sobre a etiologia e o melhor tratamento. Entre as terapêuticas propostas, a cirurgia, aplicação intralesional de corticóides, pressoterapia, crioterapia podem ser utilizados isoladamente ou associadas

Complicaciones de la cicatrización de heridas quirúrgicas / Scarring complications of surgical wounds

Se hace referencia a la distinción entre cicatrización y cicatriz y la clasificación según el origen de esta última. Se pasa breve revista a los factores generales y locales que intervienen como complicación de la cicatrización. Se mencionan en forma de cuadro sinóptico las tres fases en que se divide el proceso de cicatrización y su tiempo de duración. Se dividen las cicatrices en viciosas y patológicas. Las primeras se definen como exageración del proceso normal de cicatrización y de las segundas, que son una neopatología, se hace referencia especial al queloide, diferenciándola de la cicatriz hipertrófica, que es una cicatriz viciosa. Breve referencia a un trabajo de investigación personal de 1966 sobre "Primeras etapas de la histogénesis del queloide provocado" y su conclusión. Se pasa revista a factores locales y generales que intervendrían en la formación de un queloide. Para concluir se formulan reglas elementales de la Cirugía dermatológica para lograr una buena cicatriz quirúrgica

Complicaciones de la cicatrización de heridas quirúrgicas / Scarring complications of surgical wounds

Se hace referencia a la distinción entre cicatrización y cicatriz y la clasificación según el origen de esta última. Se pasa breve revista a los factores generales y locales que intervienen como complicación de la cicatrización. Se mencionan en forma de cuadro sinóptico las tres fases en que se divide el proceso de cicatrización y su tiempo de duración. Se dividen las cicatrices en viciosas y patológicas. Las primeras se definen como exageración del proceso normal de cicatrización y de las segundas, que son una neopatología, se hace referencia especial al queloide, diferenciándola de la cicatriz hipertrófica, que es una cicatriz viciosa. Breve referencia a un trabajo de investigación personal de 1966 sobre "Primeras etapas de la histogénesis del queloide provocado" y su conclusión. Se pasa revista a factores locales y generales que intervendrían en la formación de un queloide. Para concluir se formulan reglas elementales de la Cirugía dermatológica para lograr una buena cicatriz quirúrgica (AU)

Principais características das cicatrizes queloideanas / Brief accout of the clinical and histological features of keloids, their treatment

Breve relato das características clínicas e histológicas dos quelóides, sua diferenciaçäo das cicatrizes hipertróficas e os vários métodos de tratamento