On the nature of keloid and hypertrophic scars

Clinical observations make it possible in most cases to differentiate between keloid and hypertrophic scars. This suggests that different biological factors are involved in the two groups. In clinical practice in the United Kingdom most keloid scars occur spontaneously. In black-skinned people and orientals the factors of keloid and hypertrophic scars may overlap and potentiate each other.     

Argon and carbon dioxide laser treatment of hypertrophic and keloid scars

Laser physiology has shown that while wound healing is generally excellent after laser impaction, it nevertheless is delayed. It is thought that this factor may be important in the treatment of hypertrophic and keloid scars. These scars have been treated in a variety of ways with the laser, and the results, which have been good, are reported. A possible explanation of the complex mode of action has been given. It is thought that more work should be undertaken in this field.     

Intra- and postoperative steroid injections for keloids and hypertrophic scars.

Treating keloids and hypertrophic scars is difficult. Here we report our method of treating recurrent keloid and hypertrophic scars. This involves surgical excision associated with intraoperative steroid injection, followed by routine weekly steroid injections for 2-5 weeks dependent on clinical signs and symptoms (pain, pruritus or paraesthesia), and monthly injections for another 3-6 months. The preliminary results thus far are promising.     

Silicone gel in the treatment of keloid scars

Silicone gel is effective in the treatment of keloid scars. Eighteen patients with 22 scars were treated with gel and their progress reviewed at 6 months. Improvements in texture, colour and height of the lesions were noted.     

病理性瘢痕中c-fos原癌基因的表达

目的　病理性瘢痕是创伤过度愈合的结果 ,以成纤维细胞的异常增殖、合成及分泌大量胶原和细胞外基质为特征 ,其形成机理仍不清楚。探讨原癌基因c -fos的表达与病理性瘢痕形成的相关性。方法　应用免疫组化SP法 ,检测c -fos蛋白在增生性瘢痕、瘢痕疙瘩及正常皮肤组织中的表达和分布 ,并用图像定量分析比较其差异。结果　在增生性瘢痕和瘢痕疙瘩的成纤维细胞中c-fos呈强阳性表达 ,两组间无明显差异 ,而与正常皮肤对照组均有显著性差异。结论　增生性瘢痕与瘢痕疙瘩中c -fos蛋白表达升高 ,存在c -fos癌基因的激活 ,可能参与了成纤维细胞的分化增殖、胶原合成与降解以及对细胞因子的调控 ,并导致瘢痕增生     

病理性瘢痕中c-fos原癌基因的表达

目的　病理性瘢痕是创伤过度愈合的结果,以成纤维细胞的异常增殖、合成及分泌大量胶原和细胞外基质为特征,其形成机理仍不清楚。探讨原癌基因c-fos的表达与病理性瘢痕形成的相关性。方法　应用免疫组化SP法,检测c-fos蛋白在增生性瘢痕、瘢痕疙瘩及正常皮肤组织中的表达和分布,并用图像定量分析比较其差异。结果　在增生性瘢痕和瘢痕疙瘩的成纤维细胞中c-fos呈强阳性表达,两组间无明显差异,而与正常皮肤对照组均有显著性差异。结论　增生性瘢痕与瘢痕疙瘩中c-fos蛋白表达升高,存在c-fos癌基因的激活,可能参与了成纤维细胞的分化增殖、胶原合成与降解以及对细胞因子的调控,并导致瘢痕增生。     

Inflammatory-cell subpopulations in keloid scars.

The aim of this study was to investigate the contribution of lymphocytes and macrophages to keloid scarring by morphologically characterising inflammatory cell subpopulations in keloid scars in comparison with normal skin. We took 3mm punch biopsies from the anterior forearms of eight normal healthy volunteers. Eight keloid scars were excised using an intralesional technique. All tissue was snap frozen in liquid nitrogen and serial sections were stained with a panel of anti-inflammatory cell monoclonal antibodies. The numbers of macrophages and lymphocytes and the proportions of the subpopulations were compared. Higher numbers of both macrophages and lymphocytes were found in keloid dermis (P=0.01 and P=0.02, respectively (Mann-Whitney U -test)). There was no significant increase in the expression of the lymphocyte-activation markers, CD25 and CD27. However, there was a significantly higher CD4(+):CD8(+)(Th:Ts) ratio (P= 0.046) in keloid tissue. This suggests that an imbalance in these inflammatory cell subpopulations may contribute to keloid scarring in man.     

病理性瘢痕中原癌基因c-myc和c-fos的表达

目的　探讨原癌基因的表达与病理性瘢痕形成的相关性。方法　应用免疫组化SP法 ,检测c -myc和c -fos蛋白在增生性瘢痕、瘢痕疙瘩和正常皮肤组织中的表达和分布 ,并用图像定量分析比较其差异。结果　在增生性瘢痕和瘢痕疙瘩的成纤维细胞中c-myc、c -fos呈强阳性表达 ,两组间无明显差异 ,而与正常皮肤对照组均有显著性差异。结论　增生性瘢痕与瘢痕疙瘩中c -myc、c -fos蛋白表达升高 ,存在c -myc和c -fos原癌基因的激活 ,可能参与了成纤维细胞的分化增殖或表型转化、胶原合成与降解以及对细胞因子的调控 ,并导致瘢痕增生。     

几丁糖对增生性瘢痕和瘢痕疙瘩成纤维细胞增殖的作用

目的:探讨几丁糖对增生性瘢痕和瘢痕疙瘩成纤维细胞增殖的作用。方法:用组织块法进行瘢痕疙瘩、增生性瘢痕及正常皮肤成纤维细胞的体外培养;MTT比色法和流式细胞仪检测法分别检测不同浓度几丁糖对不同来源成纤维细胞生长增殖和细胞周期的影响。结果:各组成纤维细胞增殖明显受抑制,几丁糖的浓度和细胞OD值改变之间存在剂量-效应关系,各组成纤维细胞G_0 G_1期的细胞百分比增多,S期G_2 M期的细胞百分比减少,减少率各组无显著差异(P>0.05),S期G_2 M期的细胞百分比减少率有显著差异(P<0.05)。结论:几丁糖对正常皮肤及增生性瘢痕和瘢痕疙瘩来源的成纤维细胞的生长增殖均有抑制作用,有望在瘢痕的防治中发挥重要作用。     

Non-pressure treatment of hypertrophic scars

A silicone gel (Dow Corning X7-9119) has been successfully used in the management of hypertrophic scars. The gel softens and reduces scars in a shorter time period than pressure therapy. Relevant properties of the material and its mode of action have been investigated. The mode of action is unknown, but it is not due to pressure, temperature, oxygen tension or occlusion.