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KELOIDS AND HYPERTROPHIC SCARS

Keloids and hypertrophic scars are abnormalities in the normal wound healing characterized by greater and more sustained extracellular matrix deposition that develops after any insult in the dermis.

It can affect the patient's quality of life, both physically and psychologically.

Hypertrophic scars are raised fibrous tissue scars that remains within the boundaries of the wound. Hypertrophic scars that resulted from surgery or trauma are called linear hypertrophic scars while those from burn injuries or extensive tissue trauma and/or infections are called widespread hypertrophic scars.

Keloids are elevated fibrous scars that extend beyond the borders of the original wound. Major keloids resulted from minor trauma while for those from genetic predisposition with autosomal-predominant features are called minor keloids.

 

 

Keloids and Hypertrophic Scars References

  1. Berman B, Maderal A, Raphael B. Keloids and hypertrophic scars: pathophysiology, classification and treatment. Dermatol Surg. 2017 Jan;43(Suppl 1):S3-S18. doi: 10.1097/DSS.0000000000000819. PMID: 27347634
  2. Edriss AS, Mestak J. Management of keloid and hypertrophic scars. Ann Burns Fire Disasters. 2005 Dec;8(4):202-210. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3187998/. PMID: 21991008
  3. Gauglitz GG. Management of keloids and hypertrophic scars: current and emerging options. Clin Cosmet Investig Dermatol. 2013 Apr;6:103-114. doi: 10.2147/CCID.S35252. PMID: 23637546
  4. Gold MH, Berman B, Clementoni MT, et al. Updated international clinical recommendations on scar management: part 1-evaluating the evidence. Dermatol Surg. 2014 Aug;40(8):817-824. doi: 10.1111/dsu.0000000000000049. PMID: 25068543
  5. Gold MH, McGuire M, Mustoe TA, et al. Updated international clinical recommendations on scar management: part 2-algorithms for scar prevention and treatment. Dermatol Surg. 2014 Aug;40(8):825-831. doi: 10.1111/dsu.0000000000000050. PMID: 25068544
  6. Goldstein BG, Goldstein AO. Keloids and hypertrophic scars. UpToDate. www.uptodate.com. Feb 2018.
  7. Hultman CS, Yoshida S. Laser therapy for hypertrophic scars and keloids. UpToDate. www.uptodate.com. Apr 2018.
  8. Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician. 2009 Aug;80(3):253-260. PMID: 19621835
  9. Kim S, Choi TH, Liu W, et al. Update on scar management: guidelines for treating Asian patients. Plast Reconstr Surg. 2013 Dec;132(6):1580-1589. doi: 10.1097/PRS.0b013e3182a8070c. PMID: 24281584
  10. Leong M, Murphy KD, Philips LG. Wound healing. In: Townsend CM, Beauchamp DR, Evers MB, Mattox, KL, eds. Sabiston Textbook of Surgery. 12th. Philadelphia, PA: Elsevier, Inc; 2017:141-143.
  11. Lorenz P, Sina Bari A. Scar prevention, treatment and revision. In: Neligan PC ed. Plastic Surgery. 3rd. Philadelphia, PA: Elsevier Inc; 2013. 297-318. :297-318.
  12. Meaume S, Le Pillouer-Prost A, Richert B, Roseeuw D, Vadoud J. Management of scars: updated practical guidelines and use of silicones. Eur J Dermatol. 2014 Jul;24(4):435-443. doi: 10.1684/ejd.2014.2356. PMID: 25141160
  13. Monstrey S, Middelkoop E, Vranckx JJ, et al. Updated scar management practical guidelines: non-invasive and invasive measures. J Plast Reconstr Aesthet Surg. 2014 Aug;67(8):1017-1025. doi: 10.1016/j.bjps.2014.04.011. Accessed 20 Jul 2016. PMID: 24888226
  14. Nast A, Eming S, Fluhr J, et al; German Society of Dermatology. German S2k guidelines for the therapy of pathological scars (hypertrophic scars and keloids). J Dtsch Dermatol Ges. 2012 Oct;10(10):747-762. doi: 10.1111/j.1610-0387.2012.08012.x. PMID: 22937806
  15. Viera MH, Amini S, Valins W, et al. Innovative therapies in the treatment of keloids and hypertrophic scars. J Clin Aesthet Dermatol. 2010 May;3(5):20-26. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2922716. PMID: 20725565
  16. Yun IS, Yoo HS, Kim Yo, et al. Improved scar appearance with combined use of silicone gel and vitamin C for Asian patients: a comparative case series. Aesthetic Plast Surg. 2013 Dec;37(6):1176-1181. doi: 10.1007/s00266-013-0210-5. PMID: 24091488
  17. Khansa I, Harrison B, Janis JE. Evidence-based scar management: How to improve results with technique and technology. Plast Reconstr Surg. 2016 Sep;138(Suppl 3):165S-1678S. doi: 10.1097/PRS.0000000000002647. PMID: 27556757
  18. Telang PS. Vitamin C in dermatology. Indian Dermatol Online. 2013 Apr;4(2):143-146. doi: 10.4103/2229-5178.110593. PMID: 23741676
  19. McLaughlin J, Branski LK, Norbury WB, et al. Laser for burn scar treatment. In: Herndon DN. Total burn care. 5th: Elsevier Inc.; 2018:648-654.
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