A case–control study analyzing the association of keloids with hypertension and obesity

Rutherford, Audrey; Glass, Donald A.

doi:10.1111/ijd.13618

Cited by 15 publications

(19 citation statements)

References 6 publications

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“…Hypertension Hypothesis Dustan (1995) first hypothesized that the differences in growth factor abnormalities that are conducive to keloid scarring in the black population, could also be responsible for the development of hypertension and therefore explain the differences in hypertension severity between the black and white population. A significant increase in hypertension rates has in fact been reported in keloid-prone patients compared with non-keloid formers in both the African-American (Snyder et al, 1996;Adotama et al, 2016;Rutherford and Glass, 2017) and Caucasian population (Snyder et al, 1996). Ogawa et al (2013) also reported that severe keloid cases (multiple or large >10 cm 2 ) in Japan were significantly more likely to have hypertension than patients with mild keloids (<2 or <10 cm 2 ).…”

Section: Psychoneuroimmune-endocrine Hypothesismentioning

confidence: 99%

The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models

Limandjaja

Niessen

Scheper

et al. 2020

Front. Cell Dev. Biol.

227

274

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Section: Psychoneuroimmune-endocrine Hypothesismentioning

confidence: 99%

The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models

Limandjaja

Niessen

Scheper

et al. 2020

Front. Cell Dev. Biol.

227

274

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“…2 Finally, scar tissue that grows beyond the confines of the original insult and invades surrounding tissue (ie, keloid formation) demonstrates that fibrosis in the skin similarly can be associated with obesity. 3 The most recent American Thoracic Society/European Respiratory Society/Japanese Respiratory Society/Latin American Thoracic Association (ATS/ERS/JRS/ALAT) guidelines integrate high-resolution computed tomography (HRCT) imaging patterns, surgical lung biopsy patterns, and multidisciplinary discussion to diagnose idiopathic pulmonary fibrosis (IPF), a chronic, progressive lung fibrosis of unknown cause and the most common idiopathic interstitial pneumonia. 4 The progression and mortality of IPF depend on a variety of patient characteristics.…”

mentioning

confidence: 99%

Outcomes of Idiopathic Pulmonary Fibrosis Improve with Obesity: A Rural Appalachian Experience

Sangani¹,

Ghio²,

Mujahid³

et al. 2021

Southern Medical Journal

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Objectives: Obesity can be an independent predictor of fibrosis in tissues, including the liver, heart, and skin. We evaluated a rural Appalachian cohort of idiopathic pulmonary fibrosis (IPF) for its relation to obesity.Methods: Using American Thoracic Society 2018 diagnostic guidelines, an IPF cohort was systematically identified at an Appalachian academic medical center (2015)(2016)(2017)(2018)(2019). The cohort was categorized in subgroups of body mass index (BMI) <30 or BMI ≥30 kg/m 2 . Demographics, clinical variables, and treatment details were collected retrospectively and evaluated for their associations with obesity.Results: In our IPF cohort (N = 138), a usual interstitial pneumonia pattern was less prevalent in the obese group (n = 49) relative to the nonobese group (69% vs 85%, respectively). The obese group was younger (mean age 73.27 ± 9.12 vs 77.97 ± 9.59 years) and had a higher prevalence of hypertension (90% vs 72%), hyperlipidemia (83% vs 68%), diabetes mellitus (47% vs 25%), sleep-disordered breathing (47% vs 25%), chronic pain disorders (28% vs 15%), and deep vein thrombosis (19% vs 7%). An increased proportion of obese-IPF patients was seen at a tertiary or an interstitial lung disease center, with more surgical lung biopsies performed and incident diagnosis (ie, within 6 months of presentation) assigned. Only a minority of patients underwent lung transplantation (3.6%), all of them from the obese-IPF subgroup. Approximately 30% of the total IPF cohort died, with a lower mortality observed in the obese group (35% vs 20%, P = 0.017). An increasing BMI predicted a better survival in the total IPF cohort (BMI 25-29.9, 20-24.9, and <20 had mortality rates of 20%, 47%, and 75%, respectively; P < 0.001). Conclusions:Our study represents a first known effort to develop an IPF cohort in a rural Appalachian region. Although they shared an increased burden of comorbidities, the obese subgroup showed less advanced fibrosis with a lower mortality rate relative to nonobese subgroup, suggesting a potential "obesity paradox" in IPF. The study findings significantly advance our understanding of challenges posed by IPF in a rural population that also suffers from an alarming rate of obesity. We highlight the need for the multidisciplinary management of these patients and prospective studies to better define this complex relation.

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“…Moreover, ear keloids are significantly associated with obesity. 16 In the present study, the high prevalence of morbidities in the keloids cohort suggests that morbidities may contribute to the underlying pathogenesis of keloids. Second, interaction between mast cell hyperplasia and myofibroblast differentiation has been documented in fibrotic disease 17 ; additionally, meningeal and brain mast cells linked with dural neurons modulate meningeal nociceptor activity and migraine genesis.…”

Section: Risks Factors For Migraine In Keloids Groupmentioning

confidence: 53%

Migraines and keloids: a 15-year Taiwan claim database analysis

Qin

et al. 2021

Postgraduate Medical Journal

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BackgroundFibroproliferative lesions with intractable pruritus, pain and hyperesthesia that cause uncontrolled scar growth are known as keloids. Migraines are common upsetting headache disorders characterised by frequent recurrence and attacks aggravated by physical activity. Both keloids and migraines can cause physical exhaustion and discomfort in patients; they have similar pathophysiological pathways, that is, the transforming growth factor-β1 gene and neurogenic inflammation.ObjectiveTo investigate subsequent development of migraines in patients with keloids.MethodsData were retrieved from the Taiwan National Health Insurance Research Database. The keloids group included patients aged 20 years and older with a recent diagnosis of keloids(n=9864). The non-keloids group included patients without keloids matched for gender and age at 1–4 ratio (n=39 456). Migraine risk between groups was measured by Cox proportional hazards regression models. Incidence rates and hazard ratios were calculated.ResultsDuring the study period, 103 keloids patients and 323 non-keloids patients developed migraines. The keloids patients had a 2.29-fold greater risk of developing migraines compared with the non-keloids group after adjustment for covariates (1.81 vs 0.55 per 1000 person-years, respectively). In the keloids group, female or patients younger than 50 years were prone to developing migraines.ConclusionThe higher tendency to develop migraines in the keloids group in comparison with the non-keloids group suggests that keloids could be a predisposing risk factor for migraine development in adults. Keloids patients who complain of headaches should be examined for migraines.

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A case–control study analyzing the association of keloids with hypertension and obesity

Cited by 15 publications

References 6 publications

The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models

The Keloid Disorder: Heterogeneity, Histopathology, Mechanisms and Models

Outcomes of Idiopathic Pulmonary Fibrosis Improve with Obesity: A Rural Appalachian Experience

Migraines and keloids: a 15-year Taiwan claim database analysis

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