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Update on hypertrophic scar treatment.

Rabello FB, Souza CD, Farina Júnior JA - Clinics (Sao Paulo) (2014)

Bottom Line: Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury.Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability.This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin.

View Article: PubMed Central - PubMed

Affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

ABSTRACT
Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin.

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Related in: MedlinePlus

Keloid evolution after seven years (A and B). Keloids continue to evolve over time, without a quiescent or regressive phase, and infiltrate the surrounding tissue.
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f2-cln_69p565: Keloid evolution after seven years (A and B). Keloids continue to evolve over time, without a quiescent or regressive phase, and infiltrate the surrounding tissue.

Mentions: In contrast, keloids continue to evolve over time, without a quiescent or regressive phase and do infiltrate the surrounding tissue (Figure 2). Keloids appear as firm, mildly tender, bosselated tumors with a shiny surface and occasional telangiectasia. The epithelium is thinned and there may be focal areas of ulceration. The color is pink to purple and may be accompanied by hyperpigmentation (12). The initial lesions are erythematous and become brownish red, followed by paling as they age. The lesions preferentially develop on the earlobes, shoulders and presternal skin; are void of hair follicles and other glands; and usually project above the level of the surrounding skin (13). Keloids are primarily composed of abnormally thick, irregularly branched and septal disorganized type I and III collagen bundles without nodules and with excess myofibroblasts (11) and overproduction of multiple fibroblast proteins, indicating the persistence of wound healing or even a failure to downregulate wound-healing cells. In addition, keloids are not triggered to enter the final phase of wound healing, or the “remodeling” phase, whereas HTSs will eventually do so (14).


Update on hypertrophic scar treatment.

Rabello FB, Souza CD, Farina Júnior JA - Clinics (Sao Paulo) (2014)

Keloid evolution after seven years (A and B). Keloids continue to evolve over time, without a quiescent or regressive phase, and infiltrate the surrounding tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4129552&req=5

f2-cln_69p565: Keloid evolution after seven years (A and B). Keloids continue to evolve over time, without a quiescent or regressive phase, and infiltrate the surrounding tissue.
Mentions: In contrast, keloids continue to evolve over time, without a quiescent or regressive phase and do infiltrate the surrounding tissue (Figure 2). Keloids appear as firm, mildly tender, bosselated tumors with a shiny surface and occasional telangiectasia. The epithelium is thinned and there may be focal areas of ulceration. The color is pink to purple and may be accompanied by hyperpigmentation (12). The initial lesions are erythematous and become brownish red, followed by paling as they age. The lesions preferentially develop on the earlobes, shoulders and presternal skin; are void of hair follicles and other glands; and usually project above the level of the surrounding skin (13). Keloids are primarily composed of abnormally thick, irregularly branched and septal disorganized type I and III collagen bundles without nodules and with excess myofibroblasts (11) and overproduction of multiple fibroblast proteins, indicating the persistence of wound healing or even a failure to downregulate wound-healing cells. In addition, keloids are not triggered to enter the final phase of wound healing, or the “remodeling” phase, whereas HTSs will eventually do so (14).

Bottom Line: Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury.Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability.This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin.

View Article: PubMed Central - PubMed

Affiliation: Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.

ABSTRACT
Scar formation is a consequence of the wound healing process that occurs when body tissues are damaged by a physical injury. Hypertrophic scars and keloids are pathological scars resulting from abnormal responses to trauma and can be itchy and painful, causing serious functional and cosmetic disability. The current review will focus on the definition of hypertrophic scars, distinguishing them from keloids and on the various methods for treating hypertrophic scarring that have been described in the literature, including treatments with clearly proven efficiency and therapies with doubtful benefits. Numerous methods have been described for the treatment of abnormal scars, but to date, the optimal treatment method has not been established. This review will explore the differences between different types of nonsurgical management of hypertrophic scars, focusing on the indications, uses, mechanisms of action, associations and efficacies of the following therapies: silicone, pressure garments, onion extract, intralesional corticoid injections and bleomycin.

Show MeSH
Related in: MedlinePlus