Are keloid and hypertrophic scar different forms of the same disorder? A fibroproliferative skin disorder hypothesis based on keloid findings
Are keloid and hypertrophic scar different forms of the same disorder? A fibroproliferative skin disorder hypothesis based on keloid findings
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DOI：
10.1111/j.1742-481x.2012.01118.x
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发表时间：
2014-10-01
影响因子：
3.1
通讯作者：
Ogawa, Rei
中科院分区：
文献类型：
--
作者：
Huang, Chenyu;Akaishi, Satoshi;Ogawa, Rei
增生性瘢痕和瘢痕疙瘩通常被临床医生和病理学家视为两种不同的疾病。然而，组织学证据表明，HS和瘢痕疙瘩可能是同一病理实体的不同形式，而不是单独的情况。为了验证这一假设，对2005-2010年间在日本医学院接受瘢痕切除手术(n=20)的患者的瘢痕疙瘩进行了组织学检查。在每个样本的中心和外围评估细胞和基质胶原成分的比例和分布。在瘢痕疙瘩标本中，发现了玻璃化胶原和真皮结节共存，这是瘢痕疙瘩最重要的病理特征，而真皮结节被认为是HS的特征。此外，透明纤维似乎从真皮结节的角落开始。炎症的主要特征，如微血管、成纤维细胞和炎症细胞等，从瘢痕疙瘩周围到中心逐渐减少，表明中心的炎症减轻。因此，我们假设HS和瘢痕疙瘩可以被认为是同一纤维增生性皮肤病的连续阶段，具有不同程度的炎症，可能受到遗传易感性的影响。
Hypertrophic scars (HSs) and keloids are commonly seen as two different diseases by both clinicians and pathologists. However, as supported by histological evidence showing they share increased numbers of fibroblasts and accumulate collagen products, HS and keloid might be different forms of the same pathological entity, rather than separate conditions. To test this hypothesis, keloids from patients who underwent scar excisions (n = 20) in Nippon Medical School from 2005 to 2010 were examined histologically. The proportion and distribution of cellular and matrix collagen components were evaluated at the centre and periphery of each sample. In keloid samples, coexistence of hyalinised collagen, which is the most important pathognomonic characteristic of a keloid and dermal nodules that are considered to be characteristic of HS, was found. Moreover, hyalinised fibres appeared to initiate from the corner of the dermal nodules. Key features of inflammation such as microvessels, fibroblasts and inflammatory cells all decreased gradually from the periphery to the centre of keloids, indicative of reduced inflammation in the centre. Thus, we hypothesise that HS and keloid can be considered as successive stages of the same fibroproliferative skin disorder, with differing degrees of inflammation that might be affected by genetic predisposition.