Nd

Koike, Sachiko; Akaishi, Satoshi; Nagashima, Yuki; Dohi, Teruyuki; Hyakusoku, Hiko; Ogawa, Rei

doi:10.1097/gox.0000000000000231

Cited by 70 publications

(29 citation statements)

References 20 publications

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“…Pulsed dye laser [22] or long-pulsed Nd:YAG laser [23] therapy reduces the objective and subjective symptoms of keloids and hypertrophic scars (Figure 4). The known target of these lasers is the blood vessels.…”

Section: Treatment Of Keloids and Hypertrophic Scarsmentioning

confidence: 99%

Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

Ogawa

2017

IJMS

Self Cite

670

616

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Keloids and hypertrophic scars are caused by cutaneous injury and irritation, including trauma, insect bite, burn, surgery, vaccination, skin piercing, acne, folliculitis, chicken pox, and herpes zoster infection. Notably, superficial injuries that do not reach the reticular dermis never cause keloidal and hypertrophic scarring. This suggests that these pathological scars are due to injury to this skin layer and the subsequent aberrant wound healing therein. The latter is characterized by continuous and histologically localized inflammation. As a result, the reticular layer of keloids and hypertrophic scars contains inflammatory cells, increased numbers of fibroblasts, newly formed blood vessels, and collagen deposits. Moreover, proinflammatory factors, such as interleukin (IL)-1α, IL-1β, IL-6, and tumor necrosis factor-α are upregulated in keloid tissues, which suggests that, in patients with keloids, proinflammatory genes in the skin are sensitive to trauma. This may promote chronic inflammation, which in turn may cause the invasive growth of keloids. In addition, the upregulation of proinflammatory factors in pathological scars suggests that, rather than being skin tumors, keloids and hypertrophic scars are inflammatory disorders of skin, specifically inflammatory disorders of the reticular dermis. Various external and internal post-wounding stimuli may promote reticular inflammation. The nature of these stimuli most likely shapes the characteristics, quantity, and course of keloids and hypertrophic scars. Specifically, it is likely that the intensity, frequency, and duration of these stimuli determine how quickly the scars appear, the direction and speed of growth, and the intensity of symptoms. These proinflammatory stimuli include a variety of local, systemic, and genetic factors. These observations together suggest that the clinical differences between keloids and hypertrophic scars merely reflect differences in the intensity, frequency, and duration of the inflammation of the reticular dermis. At present, physicians cannot (or at least find it very difficult to) control systemic and genetic risk factors of keloids and hypertrophic scars. However, they can use a number of treatment modalities that all, interestingly, act by reducing inflammation. They include corticosteroid injection/tape/ointment, radiotherapy, cryotherapy, compression therapy, stabilization therapy, 5-fluorouracil (5-FU) therapy, and surgical methods that reduce skin tension.

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Section: Treatment Of Keloids and Hypertrophic Scarsmentioning

confidence: 99%

Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

Ogawa

2017

IJMS

Self Cite

670

616

View full text Add to dashboard Cite

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“…The 1064-nm Nd:YAG laser is another popular laser for treating hypertrophic scars and keloids. For this laser, the recommended energy is 14 J/cm 2 (5-mm spot), with the procedure being repeated every three to four weeks [ 115 , 116 ]. These laser treatments vaporize blood vessels.…”

Section: Preventions and Treatment Strategies For Hypertrophic Scamentioning

confidence: 99%

Recent Understandings of Biology, Prophylaxis and Treatment Strategies for Hypertrophic Scars and Keloids

Lee

Jang

2018

IJMS

361

327

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Hypertrophic scars and keloids are fibroproliferative disorders that may arise after any deep cutaneous injury caused by trauma, burns, surgery, etc. Hypertrophic scars and keloids are cosmetically problematic, and in combination with functional problems such as contractures and subjective symptoms including pruritus, these significantly affect patients’ quality of life. There have been many studies on hypertrophic scars and keloids; but the mechanisms underlying scar formation have not yet been well established, and prophylactic and treatment strategies remain unsatisfactory. In this review, the authors introduce and summarize classical concepts surrounding wound healing and review recent understandings of the biology, prevention and treatment strategies for hypertrophic scars and keloids.

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“…Laser therapy such as PDL, CO 2 and Nd:YAG have been associated with a high rate of recurrence at 6–24 months. 111 , 113 – 115 However, optimal results can be achieved with combination treatment especially with intralesional TAC injections. 116 – 118 Kumar and co-workers conducted a cohort study on 17 patients with keloids previously treated with an Nd:YAG laser and reported complete scar resolution and flattening in seven patients only when intralesional TAC was used after laser therapy.…”

Section: Current Treatmentsmentioning

confidence: 99%

Keloids: Current and emerging therapies

Ojeh

Bharatha

Gaur

et al. 2020

Scars, Burns & Healing

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Keloids are pathological scars that grow over time and extend beyond the initial site of injury after impaired wound healing. These scars frequently recur and rarely regress. They are aesthetically disfiguring, can cause pain, itching, discomfort as well as psychological stress, often affecting quality of life. Many treatment modalities, including surgical and non-surgical, have been explored and have been reported to be beneficial; however, none have been absolutely satisfactory or optimal for the treatment of all keloid subtypes to date. This poses a major challenge to clinicians. Often, a combinational therapeutic approach appears to offer the best results with higher patient satisfaction compared to monotherapy. The aetiopathogenesis of keloids is not fully elucidated; however, with recent advances in molecular biology and genetics, insight is being gained on the complex process of scar formation and hence new therapeutic and management options for keloids. In this paper, we explore the literature and summarise the general concepts surrounding keloid development and review both current (corticosteroids, surgical excision, silicone-based products, pressure therapy, radiotherapy, cryotherapy, laser therapy, imiquimod and 5-fluorouracil) and emerging (stem cell therapy, mitomycin C, verapamil, interferons, bleomycin, botulinum toxin type A and angiotensin-converting enzyme inhibitors) treatments. Increased knowledge and understanding in this area may potentially lead to the discovery and development of novel therapeutic options that are more efficacious for all keloid types. Lay Summary [Formula: see text] Keloids are problematic scars that are difficult to treat and manage. The aetiopathogenesis of keloids is not clear; however, recent advances in molecular biology and genetics are beginning to shed light on the underlying mechanisms implicated in keloid scar formation which will hopefully lead to the development of treatment options for all keloid types. This review summarises current and emerging therapies.

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Nd

Cited by 70 publications

References 20 publications

Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis

Recent Understandings of Biology, Prophylaxis and Treatment Strategies for Hypertrophic Scars and Keloids

Keloids: Current and emerging therapies

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