ABSTRACT
As cicatrizes queloidianas afetam diversas populações, comprometendo a qualidade de vida dos pacientes. Vários tratamentos são apresentados na literatura. O presente estudo visou a realização de uma revisão integrativa dos artigos de revisões sistemáticas e/ou metanálises que abordam o seu tratamento nas bases de dados PubMed, LILACS, MEDLINE e Cochrane no período de 2015 a 2021. Após a identificação, e seguindo os critérios de seleção e elegibilidade, foram incluídos 24 artigos para revisão qualitativa. Observamos que as diferentes modalidades de tratamento empregadas para os queloides são afetadas pela dificuldade de avaliar recorrência, ainda mantendo muitas taxas de insucesso e necessidade de novos estudos.
Keloid scars affect different populations, compromising patients' quality of life. The literature presents several treatments. The study aimed to conduct an integrative review of systematic review articles and/or meta-analyses addressing keloid treatment in the PubMed, LILACS, MEDLINE, and Cochrane databases from 2015 to 2021. After identification and following the selection and eligibility criteria, 24 articles were included for qualitative review. We observed that the difficulty in evaluating recurrence affected different keloids treatment modalities, still presenting many failure rates and the need for further studies.
ABSTRACT
BACKGROUND: Keloids and hypertrophic scars represent excessive scarring. They require different therapeutic approaches, which can be hampered because of an apparent lack of morphologic difference between the two diseases. OBJECTIVE: This study investigated the clinical and dermoscopic features of keloids and hypertrophic scars in order to help dermatologists distinguish these lesions better. METHODS: A total of 41 keloids and hypertrophic scars in 41 patients were examined clinically and by performing dermoscopy with a digital imaging system. Lesions were evaluated for vascular structures. RESULTS: Dermoscopy revealed vascular structures in most keloid lesions (90%) but in only 27% of hypertrophic scar lesions. The most common dermoscopic vascular structures in keloids were arborizing (52%), followed by linear irregular (33%) and commashaped (15%); these features were present but less evident in hypertrophic scars (9% for all types). The distribution frequency of the vascular structures differed significantly between diseases (p<0.001). CONCLUSION: A strong association of vascular structures with keloids was observed on dermoscopic examination. The results suggest dermoscopic examination of vascular structures is a clinically useful diagnostic tool for differentiating between keloids and hypertrophic scars.
Subject(s)
Humans , Blood Vessels , Cicatrix , Cicatrix, Hypertrophic , Dermoscopy , KeloidABSTRACT
Objective To inVestigate the effect of emodin on hyPertroPhic scar fibroblasts ( HSFs ) and exPlore the underlying mechanism. Methods HSFs were treated by emodin at final concentrations of 0,20,40,and 80 μmol·L-1, resPectiVely,in the cultural media. Forty_eight hours later,the cells were subjected to MTS assay and flow cytometry assay with annexin V and ProPidium iodide as dyeing indicators. Whole cell lysates from the cells of eVery grouP were subjected to Western blotting to measure the Protein exPression leVels of ERK1∕2,Bcl_2,Mcl_1 and RIP1. Results The cell Viability of HSFs was inhibited by emodin in a dose dePendent manner. The mortality rate of HSFs treated with emodin for 48 h at the concentrations of 40 and 80 μmol·L-1 were 28. 6%and 68. 0%,resPectiVely,which was significantly higher than that of the control grouP ( P<0.01).Pretreatmentwith Z_VAD_FMK could Partially reduce the mortality caused by emodin (P<0.05).PhosPhorylation of ERK1∕2 and the exPression of RIP1 and Mcl_1 were inhibited by emodin. Conclusion Down regulation of ERK1∕2,RIP1 and Mcl_1 by emodin may account for the inhibited Proliferation and increased cell death of HSFs.
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@#ObjectiveTo investigate the role of platelet-derived growth factor(PDGF) and its receptor in the development of hypertrophic scar. MethodsThe expression of PDGF and its receptor were detected in biopsy specimens of 9 pieces of normal skin, 7 pieces of granulation tissue of burn wound and 34 pieces of hypertrophic scar by immunohistochemical staining using specific polyclonal antibodies.ResultsPDGF and its receptor markedly increased in granulation tissue and hypertrophic scars, reaching the peak in the hypertrophic scars within 6 months and then decreased after the peak, whereas PDGF and its receptor expressed weakly in only a few normal skin specimens, and the differences were significant(P<0.05).ConclusionsThe increasing expression of PDGF and its receptor may be related to the development of hypertrophic scar.
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Objective:To probe into the effects of tetrandrine on fibroblast proliferation derived from hypertrophic scars and evaluate the role of tetrandrine in the treatment of scars.Methods:Taking the cultured fibroblasts derived from human hypertrophic scars as model,the effects of tetrandrine on fibroblast proliferation and content of extracellular collagen were observed and analyzed by MTT reduction assay,flow cytometry after propidium iodide staining and modified chloraseptine T oxidizing assay.Besides,their relationship was analyzed by linear correlation.Results:Growth curve descent,TD prolonging and extracellular collagen reduction in a dosage and time dependent manner were observed.Moreover,they changed in positive correlation with each other.Conclusion:Tetrandrine can inhibit fibroblast biological action derived from hypertrophic scars,which is one of the mechanism of anti-scarring action of tetrandrine.