The DOI matches its Crossref record; 85 of the 85 references it cites were found in a registry or an index.
Keloids and Hypertrophic Scars: Pathophysiology, Classification, and Treatment
Abstract
BACKGROUND: Keloid and hypertrophic scars represent an aberrant response to the wound healing process. These scars are characterized by dysregulated growth with excessive collagen formation, and can be cosmetically and functionally disruptive to patients. OBJECTIVE: Objectives are to describe the pathophysiology of keloid and hypertrophic scar, and to compare differences with the normal wound healing process. The classification of keloids and hypertrophic scars are then discussed. Finally, various treatment options including prevention, conventional therapies, surgical therapies, and adjuvant therapies are described in detail. MATERIALS AND METHODS: Literature review was performed identifying relevant publications pertaining to the pathophysiology, classification, and treatment of keloid and hypertrophic scars. RESULTS: Though the pathophysiology of keloid and hypertrophic scars is not completely known, various cytokines have been implicated, including interleukin (IL)-6, IL-8, and IL-10, as well as various growth factors including transforming growth factor-beta and platelet-derived growth factor. Numerous treatments have been studied for keloid and hypertrophic scars,which include conventional therapies such as occlusive dressings, compression therapy, and steroids; surgical therapies such as excision and cryosurgery; and adjuvant and emerging therapies including radiation therapy, interferon, 5-fluorouracil, imiquimod, tacrolimus, sirolimus, bleomycin, doxorubicin, transforming growth factor-beta, epidermal growth factor, verapamil, retinoic acid, tamoxifen, botulinum toxin A, onion extract, silicone-based camouflage, hydrogel scaffold, and skin tension offloading device. CONCLUSION: Keloid and hypertrophic scars remain a challenging condition, with potential cosmetic and functional consequences to patients. Several therapies exist which function through different mechanisms. Better understanding into the pathogenesis will allow for development of newer and more targeted therapies in the future.
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Cites
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Extracellular matrix rigidity governs smooth muscle cell motility in a biphasic fashion
Peyton, S. R., & Putnam, A. J. (2005) · Journal of Cellular Physiology · doi:10.1002/jcp.20274 · Cited by 657
Transforming growth factor βs and wound healing
O'Kane, S., & Ferguson, M. W. J. (1997) · The International Journal of Biochemistry & Cell Biology · doi:10.1016/s1357-2725(96)00120-3 · Cited by 634
Focal adhesion kinase links mechanical force to skin fibrosis via inflammatory signaling
Wong, V. W., Rustad, K. C., Akaishi, S., Sorkin, M., Glotzbach, J. P., Januszyk, M., Nelson, E. R., Levi, K., Paterno, J., Vial, I. N., et al. (2012) · Nature Medicine · doi:10.1038/nm.2574 · Cited by 515
Neutralising antibody to TGF-β1,2 reduces cutaneous scarring in adult rodents
Shah, M., Foreman, D. M., & Ferguson, M. W. J. (1994) · Journal of Cell Science · doi:10.1242/jcs.107.5.1137 · Cited by 498
Wound Healing in the PU.1 Null Mouse—Tissue Repair Is Not Dependent on Inflammatory Cells
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Silicone gel sheeting for preventing and treating hypertrophic and keloid scars
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The Most Current Algorithms for the Treatment and Prevention of Hypertrophic Scars and Keloids
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Cited by
Microneedle-mediated transdermal drug delivery for treating diverse skin diseases
Yang, D., Chen, M., Sun, Y., Jin, Y., Lu, C., Pan, X., Quan, G., & Wu, C. (2021) · Acta Biomaterialia · doi:10.1016/j.actbio.2020.12.004 · Cited by 259
Estrogen Effects on Wound Healing
Horng, H.-C., Chang, W.-H., Yeh, C.-C., Huang, B.-S., Chang, C.-P., Chen, Y.-J., Tsui, K.-H., & Wang, P.-H. (2017) · International Journal of Molecular Sciences · doi:10.3390/ijms18112325 · Cited by 208
Skin biomechanics: a potential therapeutic intervention target to reduce scarring
Hosseini, M., Brown, J., Khosrotehrani, K., Bayat, A., & Shafiee, A. (2022) · Burns & Trauma · doi:10.1093/burnst/tkac036 · Cited by 78
From Grafts to Human Bioengineered Vascularized Skin Substitutes
Oualla-Bachiri, W., Fernández-González, A., Quiñones-Vico, M. I., & Arias-Santiago, S. (2020) · International Journal of Molecular Sciences · doi:10.3390/ijms21218197 · Cited by 69
Brouwer, H. F. M., Mansoor, A. K., Dekker, S., Bouten, C. V. C., Ito, K., Foolen, J., & Smits, A. I. P. M. (2026) · Tissue Engineering and Regenerative Medicine · doi:10.1007/s13770-025-00766-1 · Cited by 5
Metadata
- Authors
- Berman, B., Maderal, A., & Raphael, B.
- Venue
- Dermatologic Surgery
- Published
- 2017-01
- Volume
- 43
- Issue
- 1
- Pages
- S3-S18
- ISSN
- 1076-0512 (ISSN-L)
- 1524-4725
- OpenAlex
- W2471222887
- Cited by
- 687
- References
- 85
- FWCI
- 31.77
- Type
- journal article
- Language
- en
- Open access
- closed
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