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1.
Biomed Eng Online ; 21(1): 2, 2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-35012558

RESUMO

BACKGROUND: The role of epithelial-mesenchymal transition (EMT) in the pathogenesis of keloids is currently raising increasing attention. Long noncoding RNAs (lncRNAs) govern a variety of biological processes, such as EMT, and their dysregulation is involved in many diseases including keloid disease. The aim of this study was to identify differentially expressed EMT-related lncRNAs in keloid tissues versus normal tissues and to interpret their functions. RESULTS: Eleven lncRNAs and 16 mRNAs associated with EMT were identified to have differential expression between keloid and normal skin tissues (fold change > 1.5, P < 0.05). Gene Ontology (GO) analysis showed that these differentially expressed mRNAs functioned in the extracellular matrix, protein binding, the positive regulation of cellular processes, the Set1C/COMPASS complex and histone acetyltransferase activity. Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis demonstrated that these mRNAs are involved in pathways in cancer. The lncRNA, XLOC_000587 may promote cell proliferation and migration by enhancing the expression of ENAH, while AF268386 may facilitate the invasive growth of keloids by upregulating DDR2. CONCLUSIONS: We characterized the differential expression profiles of EMT-related lncRNAs and mRNAs in keloids, which may contribute to preventing the occurrence and development of keloids by targeting the corresponding signaling pathways. These lncRNAs and mRNAs may provide biomarkers for keloid diagnosis and serve as potential targets for the treatment of this disease.


Assuntos
Queloide , RNA Longo não Codificante , Transição Epitelial-Mesenquimal , Perfilação da Expressão Gênica , Humanos , Queloide/patologia , RNA Mensageiro , Transdução de Sinais
2.
Zhonghua Shao Shang Za Zhi ; 37(12): 1194-1198, 2021 Dec 20.
Artigo em Chinês | MEDLINE | ID: mdl-34937156

RESUMO

Pathologically, scars are divided into physiological scars and pathological scars, and the latter mainly include hyperplastic scars and keloids. Scar treatment includes surgical treatment and non-surgical treatment, with the pathological scars as the major targets in treatment. Until now, there is no treatment with ideal therapeutic effect. Therefore, new therapeutic methods for pathological scars are still being explored at home and abroad. In recent years, some non-surgical therapeutic methods for scars that have received widespread attention have emerged. In this article, several problems worthy of attention including intralesional injection therapy, photoelectric therapy, and rehabilitation robots were discussed.


Assuntos
Cicatriz Hipertrófica , Queloide , Atenção , Cicatriz Hipertrófica/patologia , Cicatriz Hipertrófica/terapia , Humanos , Injeções Intralesionais , Queloide/patologia
3.
Int J Mol Sci ; 22(19)2021 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-34639105

RESUMO

Keloids are a common form of pathologic wound healing and are characterized by an excessive production of extracellular matrix. This study examined the major contributing mechanism of human keloid pathogenesis using transcriptomic analysis. We identified the upregulation of mitochondrial oxidative stress response, protein processing in the endoplasmic reticulum, and TGF-ß signaling in human keloid tissue samples compared to controls, based on ingenuity pathway and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses. Electron microscopic examinations revealed an increased number of dysmorphic mitochondria and expanded endoplasmic reticulum (ER) in human keloid tissue samples than that in controls. Western blot analysis performed using human tissues suggested noticeably higher ER stress signaling in keloids than in normal tissues. Treatment with tauroursodeoxycholic acid (TUDCA), an ER stress inhibitor, significantly decreased scar formation in rabbit models, compared to normal saline and steroid injections. In summary, our findings demonstrate the contributions of mitochondrial dysfunction and dysregulated ER stress signaling in human keloid formation and the potential of TUDCA in the treatment of keloids.


Assuntos
Colagogos e Coleréticos/farmacologia , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Queloide/prevenção & controle , Ácido Tauroquenodesoxicólico/farmacologia , Adulto , Animais , Apoptose , Estudos de Casos e Controles , Feminino , Humanos , Queloide/etiologia , Queloide/metabolismo , Queloide/patologia , Masculino , Coelhos , Transdução de Sinais
5.
Korean J Gastroenterol ; 78(4): 213-218, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34697275

RESUMO

Background/Aims: Anastomotic stricture at the esophagus and the conduit anastomosis site after the surgical resection of esophageal cancer is relatively common. This study examined whether a hypertrophic scar or keloid formation at a surgical wound is related to an anastomotic stricture. Methods: From March 2007 to July 2017, 59 patients underwent curative surgery for esophageal cancer. In 38 patients, end-to-end anastomosis (EEA) of the esophagus and the conduit was performed using EEA 25 mm. A hypertrophic wound scar was defined when the width of the midline laparotomy wound scar exceeded 2 mm. The relationship between the hypertrophic scar and stricture and the other risk factors for anastomotic stricture in these 38 patients was analyzed. Results: Of the 38 patients, eight patients (21.1%) had an anastomotic stricture, and a hypertrophic skin scar was observed in 14 patients (36.8%). Univariate analysis revealed lower BMI and hypertrophic scars as risk factors (p=0.032, p=0.001 respectively). Multivariate analysis revealed a hypertrophic scar as an independent risk factor for an anastomotic stricture (p=0.010, OR=27.06, 95% CI 2.19-334.40). Conclusions: Hypertrophic wound scars can be a risk factor for anastomotic stricture after surgery for esophageal cancer. An earlier prediction of anastomotic stricture by detecting hypertrophic wound healing in patients undergoing esophagectomy may improve the patients' quality of life and surgical outcomes by earlier treatments.


Assuntos
Neoplasias Esofágicas , Estenose Esofágica , Queloide , Anastomose Cirúrgica , Constrição Patológica , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/cirurgia , Estenose Esofágica/etiologia , Humanos , Queloide/diagnóstico , Queloide/etiologia , Queloide/patologia , Complicações Pós-Operatórias , Qualidade de Vida , Fatores de Risco , Estômago/patologia
6.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-bvsms | ID: lis-48452

RESUMO

Orientações de como pode ocorrer o queloide.


Assuntos
Queloide/terapia , Queloide/prevenção & controle
7.
Acta Derm Venereol ; 101(10): adv00582, 2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34518894

RESUMO

Keloids are scars that extend beyond the margins of an insulting cutaneous injury. Keloids are often thought to be primarily a cosmetic issue, as they are typically quite raised and pigmented. However, these scars also present with functional symptoms of pruritus and pain that significantly impact quality of life. The symptom of pruritus is frequently overlooked by dermatologists, and treatments are often primarily focused on the gross appearance of the scar. This review describes the prevalence and importance of pruritus in keloids. In addition, the putative mechanisms underlying the development of keloid pruritus, which include neuronal and immunological mechanisms, are discussed. Furthermore, this review describes keloid treatments that have been shown to reduce pruritus, treatments that specifically target the itch, and emerging therapies.


Assuntos
Cicatriz Hipertrófica , Queloide , Terapia Combinada , Humanos , Queloide/diagnóstico , Queloide/patologia , Queloide/terapia , Dor , Prurido/diagnóstico , Prurido/epidemiologia , Prurido/etiologia , Qualidade de Vida
8.
Artigo em Inglês | MEDLINE | ID: mdl-34535218

RESUMO

BACKGROUND: The Keloid is an elevated fibrous scar that may extend beyond the borders of the original wound. OBJECT: To compare between topical and intralesional mitomycin C in the treatment of auricular keloids. PATIENTS AND METHODS: Prospective randomized study in which 40 patients with auricular keloids were included. The patients were divided into 2 groups, Group I included 32 patients who underwent topical mitomycin C application after the surgical removal of the auricular keloids, while Group II included 8 cases who underwent intra-lesional injection of mitomycin C after surgical removal of the auricular keloids. RESULTS: The two groups showed no significant difference regarding patient or lesion criteria (p>.05). VSS decreased significantly from 10.63 and 11.0 down to 1.38 and 3.0 after treatment in the topical and intra-lesional groups respectively (p<.001). However, greater improvement and satisfaction was detected in the topical group. CONCLUSION: Both topical and intra-lesional mitomycin C injection are effective methods in managing auricular keloids. However, better VSS scores and patient satisfaction are reported with topical administration.


Assuntos
Queloide , Administração Tópica , Humanos , Queloide/tratamento farmacológico , Mitomicina/uso terapêutico , Estudos Prospectivos , Resultado do Tratamento
9.
An Bras Dermatol ; 96(6): 759-761, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34518034

RESUMO

Histoid leprosy is a rare form of multibacillary leprosy, characterized by the presence of papules, plaques, or nodules whose appearance is keloid-like, skin colored, or erythematous. Fusiform cells are the main histopathological feature. Due to the fact that it can simulate other dermatological lesions, for example, dermatofibroma and neurofibroma, it constitutes a diagnostic challenge for clinicians and pathologists. It is a bacilliferous form of leprosy, and it plays an important role in disease transmission. A case of a patient with histoid leprosy living in the Northeast Region of Brazil is reported.


Assuntos
Queloide , Hanseníase Virchowiana , Hanseníase Multibacilar , Hanseníase , Neoplasias , Humanos , Queloide/patologia , Hanseníase/patologia , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/patologia , Hanseníase Multibacilar/diagnóstico , Hanseníase Multibacilar/tratamento farmacológico , Hanseníase Multibacilar/patologia , Pele/patologia
10.
J Drugs Dermatol ; 20(9): 964-968, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34491021

RESUMO

Keloid and hypertrophic scars are fibroproliferative disorders resulting from abnormal wound healing in genetically susceptible individuals. Current therapies are often ineffective. Kynurenine shows promise as a topical treatment for keloids and hypertrophic scars. In this study, healthy adult male and female subjects seeking treatment for mature keloid scars were enrolled. Subjects were randomized in double-blind fashion to receive kynurenic acid 0.5% (FS2) cream (Group 1), an active onion extract comparator treatment (Group 2), or the inactive vehicle (Group 3). Each treatment was applied twice-daily. Qualitative assessments were made using the Vancouver Scar Scale (VSS), as well as the Patient and Observer Scar Assessment Scales (POSAS). Among subjects in Group 1, there was a substantial decrease in mean PGSS scores after 30 days of treatment that continued to trend downward, becoming significant versus Group 2 at days 90 and 180 (P<0.05) and versus Group 3 at day 180 (P<0.01). Based on mean VSS scores, subjects in Group 1 achieved beneficial effects that became significant versus Group 2 at day 90 (P<0.01), day 120 (P<0.05), and day 180 (P<0.001) and versus Group 3 at day 180 (P<0.05). There were no significant improvements in Groups 2 or 3. There were no adverse events or local skin reactions. The twice-daily application of FS2 Cream represents a potentially new and effective treatment for mature keloid scars. J Drugs Dermatol. 2021;20(9):964-968. doi:10.36849/JDD.6197.


Assuntos
Cicatriz Hipertrófica , Queloide , Administração Tópica , Adulto , Cicatriz Hipertrófica/tratamento farmacológico , Método Duplo-Cego , Feminino , Humanos , Queloide/tratamento farmacológico , Queloide/patologia , Masculino , Pele/patologia , Resultado do Tratamento
11.
Exp Cell Res ; 408(1): 112813, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34492266

RESUMO

Keloids are benign skin tumors characterized by aggressive growth. To date, there is no exact treatment because little is known about its pathological mechanism. Therefore, it is important to investigate the mechanism of its occurrence and development to identify therapeutic targets. In this study, the expression of Kindlin-2 was higher in keloid fibroblasts (KFs) than in normal skin fibroblasts (NFs). In vitro experiments showed that knocking down Kindlin-2 in KFs could promote cell apoptosis and inhibit cell proliferation, cell migration and invasion, and contractile capability. Western blot results showed that the phosphorylation of Smad3 in KFs was inhibited after knocking down Kindlin-2, inhibiting the activation of the Smad pathway. Moreover, knocking down Kindlin-2 increased the expression of Fas and FasL in KFs, which demonstrated that knocking down Kindlin-2 promoted the activation of the exogenous apoptotic pathway of KFs and then facilitated apoptosis. The above results revealed that knocking down Kindlin-2 in KFs can inhibit the activation of the Smad pathway and promote the activation of the Fas/FasL exogenous apoptosis pathway, thereby altering the cytological function of KFs. Therefore, Kindlin-2 might play an important role in the occurrence and development of keloids and could become a new target to treat keloids.


Assuntos
Movimento Celular/fisiologia , Fibroblastos/metabolismo , Queloide/metabolismo , Proteínas de Membrana/metabolismo , Proteínas de Neoplasias/metabolismo , Adulto , Proliferação de Células/fisiologia , Células Cultivadas , Matriz Extracelular/metabolismo , Proteína Ligante Fas/metabolismo , Feminino , Fibroblastos/patologia , Humanos , Queloide/patologia , Masculino , Transdução de Sinais/fisiologia , Fator de Crescimento Transformador beta1/metabolismo
12.
Int J Mol Sci ; 22(17)2021 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-34502327

RESUMO

Keloid is an aberrant scarring process of the skin, characterized by excessive extracellular matrix synthesis and deposition. The pathogenesis of this prevalent cutaneous disorder is not fully understood; however, a persistent inflammatory process is observed. To obtain more insight into this process, we analyzed lesional, perilesional and healthy tissue using multi-antigen-analysis (MAA) in conjunction with a data mining approach. Here, we demonstrate that monocyte-derived inflammatory dendritic cells (CD1a+, CD11c+, CD14+) and activated CD4+ T lymphocytes (CD45 RO+) dominated the immune infiltration in keloids while associating with fibroblasts. In perilesional tissue, precursor immune cells were dominant in the perivascular area, suggesting that they were attracted by an immune process, potentially in the lesional area. Supporting this hypothesis, only in keloid lesions, high levels of ADAM10/17 and Neprilysin (CD10) were observed in both fibroblasts and leukocytes. The spatial proximity of these two cell types, which could be confirmed by image analysis only in lesional tissue, could be a potential factor leading to the activation of fibroblasts. Our findings provide new insight into the pathogenesis of keloid formation and reveal metalloproteinases as a target for therapeutical intervention.


Assuntos
Proteína ADAM17/metabolismo , Células Dendríticas/imunologia , Fibroblastos/patologia , Inflamação/patologia , Queloide/patologia , Neprilisina/metabolismo , Adolescente , Adulto , Estudos de Casos e Controles , Células Cultivadas , Fibroblastos/imunologia , Fibroblastos/metabolismo , Humanos , Inflamação/imunologia , Inflamação/metabolismo , Queloide/imunologia , Queloide/metabolismo , Pessoa de Meia-Idade , Adulto Jovem
13.
Chin Med J (Engl) ; 134(18): 2205-2213, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34553702

RESUMO

BACKGROUND: Hyperbaric oxygen treatment (HBOT) has been demonstrated to influence the keloid recurrence rate after surgery and to relieve keloid symptoms and other pathological processes in keloids. To explore the mechanism of the effect of HBOT on keloids, tumor immune gene expression and immune cell infiltration were studied in this work. METHODS: From February 2021 to April 2021, HBOT was carried out on keloid patients four times before surgery. Keloid tissue samples were collected and divided into an HBOT group (keloid with HBOT before surgery [HK] group, n = 6) and a non-HBOT group (K group, n = 6). Tumor gene expression was analyzed with an Oncomine Immune Response Research Assay kit. Data were mined with R package. The differentially expressed genes between the groups were compared. Hub genes between the groups were determined and verified with Quantitative Real-time PCR. Immune cell infiltration was analyzed based on CIBERSORT deconvolution algorithm analysis of gene expression and verified with immunohistochemistry (IHC). RESULTS: Inflammatory cell infiltration was reduced in the HK group. There were 178 upregulated genes and 217 downregulated genes. Ten hub genes were identified, including Integrin Subunit Alpha M (ITGAM), interleukin (IL)-4, IL-6, IL-2, Protein Tyrosine Phosphatase Receptor Type C (PTPRC), CD86, transforming growth factor (TGF), CD80, CTLA4, and IL-10. CD80, ITGAM, IL-4, and PTPRC with significantly downregulated expression were identified. IL-10 and IL-2 were upregulated in the HK group but without a significant difference. Infiltration differences of CD8 lymphocyte T cells, CD4 lymphocyte T-activated memory cells, and dendritic resting cells were identified with gene CIBERSORT deconvolution algorithm analysis. Infiltration levels of CD4 lymphocyte T cell in the HK group were significantly higher than those of the K group in IHC verification. CONCLUSION: HBOT affected tumor gene expression and immune cell infiltration in keloids. CD4 lymphocyte T cell, especially activated memory CD4+T, might be the key regulatory immune cell, and its related gene expression needs further study.


Assuntos
Oxigenação Hiperbárica , Queloide , Neoplasias , Expressão Gênica , Humanos , Queloide/genética , Queloide/terapia , Oxigênio
14.
An Bras Dermatol ; 96(6): 762-764, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34579963

RESUMO

Lobomycosis is a chronic granulomatous infection caused by the yeast Lacazia loboi, typically found in tropical and subtropical geographical areas. Transmission occurs through traumatic inoculation into the skin, especially in exposed areas, of men who work in contact with the soil. Lesions are restricted to the skin and subcutaneous tissue, with a keloid-like appearance in most cases. The occurrence of squamous cell carcinoma on skin lesions with a long evolution is well known; however, there are scarce reports of lobomycosis that developed into squamous cell carcinoma. The authors report a patient from the Brazilian Amazon region, with lobomycosis and carcinomatous degeneration, with an unfavorable outcome, due to late diagnosis.


Assuntos
Queloide , Lacazia , Lobomicose , Brasil , Humanos , Queloide/patologia , Lobomicose/patologia , Masculino , Pele/patologia
15.
Medicina (Kaunas) ; 57(7)2021 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-34357011

RESUMO

Keloids are a benign fibroproliferative disease with a high tendency of recurrence. Keloids cause functional impairment, disfigurement, pruritus, and low quality of life. Many therapeutic options have been used for keloids. However, the high recurrence rates have led to the use of adjuvant therapy after surgical keloid excision. There are different radiotherapy regimens available, and the advantages and disadvantages of each are still unclear. The aim of this review is to explain the appropriate radiotherapy regimen for keloids as well as discuss the recent reports on keloid management with radiotherapy. Adjuvant radiotherapy after surgical excision for keloids yields excellent local control with tolerable side effects. Hypofractionated radiotherapy with a BED of more than 28 Gy (α/ß value of 10) after excision is recommended in the light of its biologic background.


Assuntos
Queloide , Terapia Combinada , Humanos , Queloide/radioterapia , Queloide/cirurgia , Qualidade de Vida , Radioterapia Adjuvante , Recidiva , Resultado do Tratamento
16.
Cells ; 10(7)2021 07 16.
Artigo em Inglês | MEDLINE | ID: mdl-34359971

RESUMO

OBJECTIVE: Despite numerous existing treatments for keloids, the responses in the clinic have been disappointing, due to either low efficacy or side effects. Numerous studies dealing with preclinical and clinical trials have been published about effective therapies for fibrotic diseases using mesenchymal stem cells; however, no research has yet been reported to scientifically investigate the effect of human dental pulp stem cells (HDPSCs) on the treatment of keloids. The objective is to provide an experimental basis for the application of stem cells in the treatment of keloids. METHODS: Human normal fibroblasts (HNFs) and human keloid fibroblasts (HKFs) were cultured alone and in combination with HDPSCs using a transwell cell-contact-independent cell culture system. The effects of HDPSCs on HKFs were tested using a CCK-8 assay, live/dead staining assay, quantitative polymerase chain reaction, Western blot and immunofluorescence microscopy. RESULTS: HDPSCs did not inhibit the proliferation nor the apoptosis of HKFs and HNFs. HDPSCs did, however, inhibit their migration. Furthermore, HDPSCs significantly decreased the expression of profibrotic genes (CTGF, TGF-ß1 and TGF-ß2) in HKFs and KNFs (p < 0.05), except for CTGF in HNFs. Moreover, HDPSCs suppressed the extracellular matrix (ECM) synthesis in HKFs, as indicated by the decreased expression of collagen I as well as the low levels of hydroxyproline in the cell culture supernatant (p < 0.05). CONCLUSIONS: The co-culture of HDPSCs inhibits the migration of HKFs and the expression of pro-fibrotic genes, while promoting the expression of anti-fibrotic genes. HDPSCs' co-culture also inhibits the synthesis of the extracellular matrix by HKFs, whereas it does not affect the proliferation and apoptosis of HKFs. Therefore, it can be concluded that HDPSCs can themselves be used as a tool for restraining/hindering the initiation or progression of fibrotic tissue.


Assuntos
Cognição/fisiologia , Hipertrofia/metabolismo , Queloide/metabolismo , Células-Tronco/citologia , Adulto , Bioensaio/métodos , Polpa Dentária/metabolismo , Matriz Extracelular/metabolismo , Feminino , Fibroblastos/metabolismo , Humanos , Masculino
17.
Biomolecules ; 11(8)2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34439906

RESUMO

Skin fibrotic diseases, such as keloids, are mainly caused by pathologic scarring of wounds during healing and characterized by benign cutaneous overgrowths of dermal fibroblasts. Current surgical and therapeutic modalities of skin fibrosis are unsatisfactory. Pinocembrin, a natural flavonoid, has been shown to possess a vast range of pharmacological activities including antimicrobial, antioxidant, anti-inflammatory, and anti-tumor activities. In this study we explored the potential effect and mechanisms of pinocembrin on skin fibrosis in vitro and in vivo. In vitro studies indicated that pinocembrin dose-dependently suppressed proliferation, migration, and invasion of keloid fibroblasts and mouse primary dermal fibroblasts. The in vivo studies showed that pinocembrin could effectively alleviate bleomycin (BLM)-induced skin fibrosis and reduce the gross weight and fibrosis-related protein expression of keloid tissues in xenograft mice. Further mechanism studies indicated that pinocembrin could suppress TGF-ß1/Smad signaling and attenuate TGF-ß1-induced activation of skin fibroblasts. In conclusion, our results demonstrate the therapeutic potential of pinocembrin for skin fibrosis.


Assuntos
Fibrose/patologia , Flavanonas/farmacologia , Pele/efeitos dos fármacos , Pele/patologia , Fator de Crescimento Transformador beta1/metabolismo , Animais , Animais Recém-Nascidos , Movimento Celular , Proliferação de Células , Feminino , Fibroblastos/metabolismo , Flavonoides/metabolismo , Humanos , Técnicas In Vitro , Queloide/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Endogâmicos C57BL , Camundongos Nus , Invasividade Neoplásica , Transplante de Neoplasias , Cicatrização
18.
Mymensingh Med J ; 30(3): 816-825, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34226473

RESUMO

Keloids always remain a great challenge due to limited surgical treatment options. Most treatments e.g. surgery, drug therapy, radiotherapy, laser therapy, and cryotherapy for managing keloids have very limited effectiveness, for keloids grow slowly but progressively and the recurrence rate is inappreciably high. Skin expansion constitutes a potential treatment option in the treatment of large keloid. This study was intended to determine the clinical outcome of 'Tissue Expander beneath the Keloid Surgery' for repair of wound formed as a result of excision of relatively large keloids. This retrospective study was done in the Department of Dermatology and Venereology of Nantong University-affiliated Hospital, China. Using a quasi-experimental design, from August 2006 to August 2017, 75 keloids in 70 patients were implanted with tissue expanders, the capacity of which was 70-600ml. After 50-126 days of implantation, the intralesional excision with flap advancement surgery was carried out. During intraoperative period, keloid lesions were treated with beta methasone injection as 0.2ml per sq. cm of lesion and the total dose should not normally over 1-2ml per dose and postoperative superficial electron beam irradiation. Post-operative follow-up ranged from 12 to 50 months. All patients underwent keloid resection followed by radiation at postoperative day 1 and 8 with a total dose 16-18 Gy. The patient and observer scar assessment scales (POSAS) were used to evaluate changes in keloids pre- and post-operatively. Among 75 keloids, 71(94.7%) (Including 11 keloids combined with the infected site) demonstrated successful outcome, 4(5.3%) expanders in the chest failed. Infection occurred in 4(5.3%) keloids during expansion process which led to early removal of expander resulting in failure of the operation, while in the remaining 71 sites, the entire treatment process was successfully completed. Follow-up was done for more than 12 months, when 14 sites (all anterior chest) exhibited local recurrence. There was no recurrence in the 14 sites of pubic region. The total POSAS scores before surgery were 59.3±13.6 which significantly reduced to 17.7±9.1 after 12 months of surgery (p<0.001). Soft tissue expanders implantation beneath the keloid is one of the ideal methods to treat relatively large keloids, formed as a result of excision of relatively large keloids, provided the patients are carefully selected based on knowledge about possible complications.


Assuntos
Queloide , China , Humanos , Queloide/patologia , Queloide/cirurgia , Recidiva , Estudos Retrospectivos , Dispositivos para Expansão de Tecidos , Resultado do Tratamento
19.
Int J Dermatol ; 60(12): 1553-1560, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34302357

RESUMO

BACKGROUND: Ear keloids are benign, fibrous proliferations due to excessive collagen synthesis and deposition. It is a popular practice to pierce earlobes for decorative earrings and adornment; this might trigger the keloid process. Although there are varied treatment modalities, it is unsatisfactory and has always been a challenge. The aim is to evaluate the efficacy of surgical treatment with intralesional therapy in auricular keloids. METHODS: We included 30 patients with 45 keloids over the ear. Patients were evaluated (including detailed history, complete physical and local examination), and photographs and written informed consent were taken. They were treated with: excision and closure, intralesional and/or surface cryotherapy, ablative laser, intralesional steroids, and 5-fluorouracil. Excision and closure, and intralesional cryotherapy were done under local anesthesia. Closure was done after intramarginal excision with or without raising auto flaps, followed by intraoperative intralesional steroids to margins. Recurrence was assessed at 3 weeks, 3 months, 6 months, and 1 year. RESULTS: The age group of patients ranged from 14 to 57 years. A total of 32 out of 45 (71.1%) keloids were excised and were combined with intraoperative and postoperative intralesional steroid injection, with sessions depending on the patient's response. Eight (17.7%) and five (11.1%) keloids were treated using intralesional cryotherapy and only intralesional steroids, respectively. A total of 16.6% of patients had recurrence with one patient having recurrence of bilateral earlobes keloid. CONCLUSION: Keloidectomy with intraoperative and postoperative intralesional steroid injections has been very effective in the treatment of ear keloids. Different treatment modalities act synergistically, but excision surgery gives good results as it aims at maintaining ear architecture.


Assuntos
Pavilhão Auricular , Queloide , Adolescente , Adulto , Crioterapia , Pavilhão Auricular/cirurgia , Humanos , Injeções Intralesionais , Queloide/tratamento farmacológico , Queloide/cirurgia , Pessoa de Meia-Idade , Recidiva , Resultado do Tratamento , Adulto Jovem
20.
Dermatol Surg ; 47(3): 355-359, 2021 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-34328287

RESUMO

BACKGROUND: The skin of color (SOC) population in the United States continues to grow, and these patients are undergoing various cosmetic and surgical procedures at increasing rates. There is a paucity of data on the potential complications associated with surgical and cosmetic procedures in this patient population. OBJECTIVE: We aim to educate dermatologic surgeons and clinicians on surgical and cosmetic procedures in patients of color and increase awareness of the potential complications unique to this patient population. MATERIALS AND METHODS: A thorough PubMed literature search was performed to conduct this review. RESULTS: There are a number of complications in SOC that require special attention, including keloids, postoperative infections, postinflammatory hyperpigmentation, and hypopigmentation. There are also various precautions to consider when performing cosmetic procedures, such as neurotoxin and filler injections, laser therapy, microneedling, and chemical peels. CONCLUSION: Dermatologists should be aware of the potential cosmetic and surgical complications of this growing patient population to provide optimal evidence-based medical care.


Assuntos
Técnicas Cosméticas/efeitos adversos , Procedimentos Cirúrgicos Dermatológicos/efeitos adversos , Pigmentação da Pele , Abrasão Química/efeitos adversos , Agulhamento Seco/efeitos adversos , Humanos , Hiperpigmentação/etiologia , Hipopigmentação/etiologia , Queloide/etiologia , Terapia a Laser/efeitos adversos , Complicações Pós-Operatórias , Fatores de Risco , Infecção da Ferida Cirúrgica/etiologia
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