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Keloid

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2. Keloid

Keloid Keloid - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Keloid Last reviewed: February 2019 Last updated: March 2018 Summary Abnormal scarring in susceptible individuals. More common in darker skin types. Diagnosis is clinical. Treatment results are very variable. First-line options include silicone gel, intralesional corticosteroids, and pressure therapy. Surgery is reserved for patients who do not respond (...) to medical therapy, and must be given with adjuvant pressure therapy, intralesional corticosteroids, or radiotherapy to prevent recurrence. Definition A keloid is an abnormal form of scarring (a fibroproliferative disorder); it is not associated with maturation, regression, or contraction. History and exam presence of risk factors history of inciting event (e.g., body piercing, surgery, insect bite, vaccination) slow growth erythematous, smooth, and shiny elevated scar with overhanging edge itchiness

2018 BMJ Best Practice

3. Expression of Cathepsins B, D and G by the Embryonic Stem Cell-like Population within Human Keloid Tissues and keloid-derived Primary Cell Lines. (PubMed)

Expression of Cathepsins B, D and G by the Embryonic Stem Cell-like Population within Human Keloid Tissues and keloid-derived Primary Cell Lines. We have previously shown an embryonic stem cell (ESC)-like population within keloid-associated lymphoid tissues (KALTs) in keloid lesions (KLs) expresses components of the renin-angiotensin system (RAS) which maybe dysregulated. We hypothesized that cathepsin B (cathB), cathepsin D (cathD) and cathepsin G (cathG) are present within the ESC-like (...) population in KLs and contribute to bypass loops of the RAS.3,3-Diaminobenzidine (DAB) immunohistochemical (IHC) staining for cathB, cathD and cathG was performed on formalin-fixed paraffin-embedded sections in keloid tissue samples (KTS) of 11 patients. Immunofluorescence (IF) IHC staining was performed on three of these KTS, by co-staining with CD34, tryptase, and OCT4. Western blotting (WB), RT-qPCR and enzyme activity assays (EAAs) were performed on five KTS and four keloid-derived primary cell lines

2019 Plastic and reconstructive surgery

4. Partial epithelial-mesenchymal transition in keloid scars: regulation of keloid keratinocyte gene expression by transforming growth factor-β1 (PubMed)

Partial epithelial-mesenchymal transition in keloid scars: regulation of keloid keratinocyte gene expression by transforming growth factor-β1 Keloids are an extreme form of abnormal scarring that result from a pathological fibroproliferative wound healing process. The molecular mechanisms driving keloid pathology remain incompletely understood, hindering development of targeted, effective therapies. Recent studies in our laboratory demonstrated that keloid keratinocytes exhibit adhesion (...) abnormalities and display a transcriptional signature reminiscent of cells undergoing epithelial-mesenchymal transition (EMT), suggesting a role for EMT in keloid pathology. In the current study, we further define the EMT-like phenotype of keloid scars and investigate regulation of EMT-related genes in keloid.Primary keratinocytes from keloid scar and normal skin were cultured in the presence or absence of transforming growth factor beta 1 (TGF-β1) +/- inhibitors of TGF-β1 and downstream signaling pathways

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2016 Burns & trauma

5. HtrA1 Is Specifically Up-Regulated in Active Keloid Lesions and Stimulates Keloid Development (PubMed)

HtrA1 Is Specifically Up-Regulated in Active Keloid Lesions and Stimulates Keloid Development Keloids occur after failure of the wound healing process; inflammation persists, and various treatments are ineffective. Keloid pathogenesis is still unclear. We have previously analysed the gene expression profiles in keloid tissue and found that HtrA1 was markedly up-regulated in the keloid lesions. HtrA1 is a serine protease suggested to play a role in the pathogenesis of various diseases, including (...) age-related macular degeneration and osteoarthritis, by modulating extracellular matrix or cell surface proteins. We analysed HtrA1 localization and its role in keloid pathogenesis. Thirty keloid patients and twelve unrelated patients were enrolled for in situ hybridization, immunohistochemical, western blot, and cell proliferation analyses. Fibroblast-like cells expressed more HtrA1 in active keloid lesions than in surrounding lesions. The proportion of HtrA1-positive cells in keloids

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2018 International journal of molecular sciences

6. Analysis of Keloid Response to 5-Fluorouracil Treatment and Long-Term Prevention of Keloid Recurrence. (PubMed)

Analysis of Keloid Response to 5-Fluorouracil Treatment and Long-Term Prevention of Keloid Recurrence. Keloids are benign fibroproliferative skin tumors that can cause disfigurement and disability. Although they frequently recur after excision or medical management and can affect 6 to 16 percent of African Americans, there is no gold standard therapy. Keloids are challenging to study because there are no animal or in vitro models of this disorder. This makes it very difficult to validate data (...) from treated tissue samples or cells and develop targeted therapies for this disease. In this study, the authors demonstrate that intralesional 5-fluorouracil injection after keloid excision prevents recurrence for 2 years, with no reported adverse events. The authors analyze the expression of treated and untreated biopsy specimens of the same keloids in their native context to capture insights that may be missed by in vitro cell culture models and correct for intrakeloid variability. Random forest

2018 Plastic and reconstructive surgery

7. Three-dimensional poly lactic-co-glycolic acid scaffold containing autologous platelet-rich plasma supports keloid fibroblast growth and contributes to keloid formation in a nude mouse model. (PubMed)

Three-dimensional poly lactic-co-glycolic acid scaffold containing autologous platelet-rich plasma supports keloid fibroblast growth and contributes to keloid formation in a nude mouse model. There is a lack of proper animal models to study keloid formation.To create three-dimensional poly lactic-co-glycolic acid (PLGA) scaffolds containing autologous platelet-rich plasma (PRP) as an in vitro culture environment for keloid fibroblasts (KL), and to study their implantation into nude mice (...) to mimic the process of keloid formation.Normal fibroblasts (FB) and KL cells were isolated from surgical specimens and transduced with lentivirus loaded with green fluorescent protein (GFP) and luciferase genes. The FB and KL cells were three-dimensionally cultured for 14-18days in PLGA scaffolds containing PRP. Ten mice were implanted with KL cells in their left forelimbs(KL), and FB-scaffolds (FB+PLGA) in their right forelimbs. An additional ten mice were implanted with PLGA scaffolds without cells

2017 Journal of dermatological science

8. Advancing Keloid Treatment: A Novel Multimodal Approach to Ear Keloids. (PubMed)

Advancing Keloid Treatment: A Novel Multimodal Approach to Ear Keloids. Management of keloids of the pinna, in particular, those located in the helix and antihelix and lobule that occur as complications of ear piercing.Retrospective analysis of 49 patients treated with extralesional surgical excision of keloids localized to the ear followed by the application of autologous platelet-rich plasma (PRP) to wound site and postoperative in-office superficial radiation therapy (SRT). Radiation (...) protocol consisted of 1 to 3 fractions, with cumulative dosage ranging from 1,300 to 1,800 cGy. Average follow-up was 24 months to assess for evidence of recurrence and adverse side effects.Fifty ear keloids were treated with this method, age from 15 to 66 (mean = 32, SD = 16) of which 14 were male and 35 female. Almost 30% (n = 14) of patients acknowledged the source of injury that led to the development of the keloid was ear piercing. Treatment protocol achieved a 94% success rate with 3 patients who

2017 Dermatologic Surgery

9. A Case of Keloids Complicated by Castleman’s Disease: Interleukin-6 as a Keloid Risk Factor (PubMed)

A Case of Keloids Complicated by Castleman’s Disease: Interleukin-6 as a Keloid Risk Factor Keloids are a manifestation of a fibroproliferative scarring disorder of the skin and develop in response to dermal injury in patients with a susceptible background. Local, systemic, and genetic factors contribute to keloid susceptibility. These factors include tension on the edges of the wound, hormonal influences, and ethnicity, respectively. Castleman's disease is a rare lymphoproliferative disorder (...) that is characterized by the unregulated overproduction of interleukin-6, which leads to systemic lymphadenopathy and constitutional inflammatory symptoms. This case report shows that the bilateral auricular keloids of an adult woman were greatly exacerbated by the onset of Castleman's disease. We present our multimodal management algorithm for auricular keloids, which involves core excision and radiation therapy and achieves excellent aesthetic outcomes. The current treatment pathway for auricular keloids

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2017 Plastic and Reconstructive Surgery Global Open

10. The Superficial Dermis May Initiate Keloid Formation: Histological Analysis of the Keloid Dermis at Different Depths (PubMed)

The Superficial Dermis May Initiate Keloid Formation: Histological Analysis of the Keloid Dermis at Different Depths Several studies have reported on certain aspects of the characteristics of different sites within a keloid lesion, but detailed studies on the keloid dermis at different depths within a keloid lesion are scarce. The aim of this study was to investigate the histology of the keloid dermis at different depths. This study included 19 keloid tissue samples that were collected from 19 (...) patients and 19 normal skin samples, which were harvested from subjects without keloids or hypertrophic scar. Samples were studied by light microscopy using routine hematoxylin and eosin histochemical staining, and immunohistochemistry to detect CD20-positive B-lymphocytes and CD3-positive T-lymphocytes. Sirius Red histochemical staining was used to determine the type of collagen in keloid tissue and normal skin samples. The migratory properties of fibroblasts within the keloid dermis at different

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2017 Frontiers in physiology

11. Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes.

Intralesional injection treatment of hypertrophic scars and keloids: a systematic review regarding outcomes. The aim of this review was to explore the existing body of literature focusing on the intralesional treatments of keloids and hypertrophic scars.A comprehensive systematic review of related articles was conducted across multiple databases. Article selection was limited to those published in the English language between 1950 and 2014. Search terms for the on-line research were "scar(s (...) )," "keloid(s)," "hypertrophic," "injection," "intralesional," and "treatment".The initial search returned 2548 published articles. After full text review, the final search yielded 11 articles that met inclusion criteria. A total of 14 patient samples in 11 articles were collected. The most frequent intralesional injection treatment studied was triamcinolone (n = 5), followed by bleomycin (n = 3), 5-fluorouracil (n = 2), verapamil (n = 2), cryosurgery, and collagenase. The scar height reduction for all

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2017 Burns & trauma

12. Roles of peptides for prevention or treatment of hypertrophic scars and keloids: a systematic review

Roles of peptides for prevention or treatment of hypertrophic scars and keloids: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files

2019 PROSPERO

13. Clinical efficacy of intralesional botulinum toxin type a monotherapy or combination therapy with corticosteroid to inhibit hypertrophic scar and keloid: a meta-analysis

Clinical efficacy of intralesional botulinum toxin type a monotherapy or combination therapy with corticosteroid to inhibit hypertrophic scar and keloid: a meta-analysis Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability

2019 PROSPERO

14. Intralesional bleomycin injection for the treatment of hypertrophic scars and keloids: a systematic review and meta-analysis of randomised controlled trials

Intralesional bleomycin injection for the treatment of hypertrophic scars and keloids: a systematic review and meta-analysis of randomised controlled trials Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content

2019 PROSPERO

15. Neck keloids: evaluation of risk factors and recommendation for keloid staging system (PubMed)

Neck keloids: evaluation of risk factors and recommendation for keloid staging system Importance: Health care providers have long struggled with recurrent and hard to treat keloids. Advancing our understanding of natural history and risk factors for development of large, very large and massive neck keloids can lead to improved treatment outcomes. Clinical staging system for the categorization of keloid lesions, as well as grouping of keloid patients according to the extent of skin involvement (...) is both fundamental for design and delivery of proper plan of care and an absolute necessity for methodical trial design and interpretation of the results thereof. Objective: To review clinical presentation and natural history of neck keloids; to explore risk factors for development of large, very large and massive neck keloids; and to propose a clinical staging system that allows for categorization of keloid lesions by their size and grouping of keloid patients by the extent of their skin involvement

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2016 F1000Research

16. Transforming Growth Factor β Gene Signatures are Spatially Enriched in Keloid Tissue Biopsies and In vitro-Cultured Keloid Fibroblasts. (PubMed)

Transforming Growth Factor β Gene Signatures are Spatially Enriched in Keloid Tissue Biopsies and In vitro-Cultured Keloid Fibroblasts. The keloid lesion is recognised as a spatially heterogeneous mass both in cellular and acellular composition and biological activity. Here, we have utilised a bioinformatic approach to determine whether this spatial heterogeneity is also evident at the molecular level and to identify key upstream regulators of signalling pathways enriched in the lesion (...) in a spatially-restricted manner. Differentially expressed genes (20% change, p < 0.05) obtained from microarray datasets derived from whole keloid biopsies and ex vivo-cultured keloid fibroblasts, both from distinct regions of the keloid lesion (leading edge, centre, and top) have been analysed to show that the TGFβ family plays a significant but spatially dependent role in regulation of keloid gene expression. Furthermore, we have identified additional upstream signalling molecules involved in driving

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2016 Acta Dermato-Venereologica

17. Examination of Epithelial Mesenchymal Transition in Keloid Tissues and Possibility of Keloid Therapy Target (PubMed)

Examination of Epithelial Mesenchymal Transition in Keloid Tissues and Possibility of Keloid Therapy Target Keloid is a fibroproliferative skin disorder that is characterized by collagen accumulation and blood vessel proliferation in the reticular layer of the dermis. It is caused by prolonged inflammation after cutaneous injury. Several studies suggested recently that epithelial mesenchymal transition (EMT) is involved in the development of fibrosis. This study assessed whether EMT also (...) participates in keloid development and/or aggravation.Resected keloid (n = 19) and normal skin (n = 13) samples were subjected to immunohistochemical, immunofluorescent, and Western blot analyses of their expression of epidermal (E-cadherin) and mesenchymal (vimentin) proteins.Immunohistochemical analysis showed that the keloid tissues had more vimentin-positive cells in the epidermis than the normal tissues. When normal primary keratinocytes were cultured with proinflammatory cytokines, the cobblestone

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2016 Plastic and Reconstructive Surgery Global Open

18. The aldo-keto reductase AKR1B10 is upregulated in keloid epidermis, implicating retinoic acid pathway dysregulation in the pathogenesis of keloid disease. (PubMed)

The aldo-keto reductase AKR1B10 is upregulated in keloid epidermis, implicating retinoic acid pathway dysregulation in the pathogenesis of keloid disease. Keloid disease is a recurrent fibroproliferative cutaneous tumor of unknown pathogenesis for which clinical management remains unsatisfactory. To obtain new insights into hitherto underappreciated aspects of keloid pathobiology, we took a laser capture microdissection-based, whole-genome microarray analysis approach to identify distinct (...) keloid disease-associated gene expression patterns within defined keloid regions. Identification of the aldo-keto reductase enzyme AKR1B10 as highly up-regulated in keloid epidermis suggested that an imbalance of retinoic acid metabolism is likely associated with keloid disease. Here, we show that AKR1B10 transfection into normal human keratinocytes reproduced the abnormal retinoic acid pathway expression pattern we had identified in keloid epidermis. Cotransfection of AKR1B10 with a luciferase

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2016 Journal of Investigative Dermatology

19. Multi-dimensional models for functional testing of keloid scars: In silico, in vitro, organoid, organotypic, ex-vivo organ culture and in vivo models. (PubMed)

Multi-dimensional models for functional testing of keloid scars: In silico, in vitro, organoid, organotypic, ex-vivo organ culture and in vivo models. Keloid scars are described as benign fibro-proliferative dermal outgrowths that commonly occur in pigmented skin post cutaneous injury, and continue to grow beyond the boundary of the original wound margin. There is a lack of thorough understanding of keloid pathogenesis and thus keloid therapeutic options remain ill-defined. In view of the poor (...) response to current therapy and high recurrence rates, there is an unmet need in improving our knowledge and therefore in identifying targeted and effective treatment strategies in management of keloids. Keloid research however, is hampered by a lack of relevant animal models as keloids do not spontaneously occur in animals and are unique to human skin. Therefore, developing novel animal models and non-animal models for functional evaluation of keloid cells and tissue for better understanding

2019 Wound Repair and Regeneration

20. Combined Therapeutic Strategies for Keloid Treatment. (PubMed)

Combined Therapeutic Strategies for Keloid Treatment. Recent advances in keloid management favor the administration of combination therapy over monotherapy.The authors evaluated the safety and efficacy of combination therapy to treat keloids using fractional lasers, cryotherapy, and intralesional corticosteroids.The authors performed a retrospective study involving 35 Korean patients. Each patient underwent treatment using the 1,550 nm nonablative fractional erbium-glass laser, followed (...) therapy. The patients reported remarkable improvement in itching, pain, and limitations of motion after a single combination therapy session. Twenty patients were followed up for 1 year after the discontinuation of the combination treatment, and the recurrence was observed only in one patient. No significant adverse effects were observed throughout the follow-up period.Combination keloid therapy using fractional lasers, superficial cryotherapy, and intralesional triamcinolone injection is safe

2019 Dermatologic Surgery

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