The association between keloid and osteoporosis: real-world evidence

Abstract

Background Keloids are characterized by disturbance of fibroblast proliferation and apoptosis, deposition of collagen, and upregulation of dermal inflammation cells. This benign dermal fibro-proliferative scarring condition is a recognized skin inflammation disorder. Chronic inflammation is a well-known contributor to bone loss and its sequelae, osteoporosis. They both shared a similar pathogenesis through chronic inflammation. We assessed whether keloids increase osteoporosis risk through using National Health Insurance Research Database. Methods The 42,985 enrolled patients included 8597 patients with keloids but no history of osteoporosis; 34,388 controls without keloids were identified from the general population and matched at a one-to-four ratio by age, gender. Kaplan-Meier method was applied to determine cumulative incidence of osteoporosis. Cox proportional hazard regression analysis was performed after adjustment of covariates to estimate the effect of keloids on osteoporosis risk. Results Of the 8597 patients with keloids, 178 (2.07%) patients were diagnosed with osteoporosis while in the 34,388 controls, 587 (1.71%) were diagnosed with osteoporosis. That is, the keloids patients had 2.64-fold higher risk of osteoporosis compared to controls after adjustment for age, gender, Charlson Comorbidity Index and related comorbidities. The association between keloids and osteoporosis was strongest in patients younger than 50 years (hazard ratio = 7.06%) and in patients without comorbidities (hazard ratio = 4.98%). In the keloids patients, a high incidence of osteoporosis was also associated with advanced age, high Charlson Comorbidity Index score, hyperlipidemia, chronic liver disease, stroke, and depression. Conclusions Osteoporosis risk was higher in patients with keloids compared to controls, especially in young subjects and subjects without comorbidities.

Impact of seborrheic dermatitis on osteoporosis risk: A population‐based cohort study

“…Since the dataset did not include SD severity, the association between SD severity and outcome could not be determined. However, the LHID has already been used for various scientific studies of osteoporosis risk factors 57 , 58 , 59 ; our study provides additional scientific information. A final limitation is that the database lacked detailed data for osteoporosis risk factors that may have influenced the results, including relevant genetic factors, family history, sun exposure, diet/exercise habits, tobacco and alcohol consumption, and body mass index.…”

“…A final limitation is that the database lacked detailed data for osteoporosis risk factors that may have influenced the results, including relevant genetic factors, family history, sun exposure, diet/exercise habits, tobacco and alcohol consumption, and body mass index. 58 In…”

A retrospective study on the association of keloids with underlying health conditions in African-American Women

“…There have been some studies showing keloids are associated with osteoporosis, 4 leiomyomas, 5 as well as hypertension and obesity, 6–8 but the number of studies is limited. Furthermore, these studies typically have not controlled for a uniform insult to the skin, such as those who have undergone major surgical procedures.…”

“…1 Recent research suggests that keloid pathogenesis may be related to a variety of factors, including genetic, epigenetic, systemic, and local (such as mechanical tension). 3 There have been some studies showing keloids are associated with osteoporosis, 4 leiomyomas, 5 as well as hypertension and obesity, [6][7][8] but the number of studies is limited. Furthermore, these studies typically have not controlled for a uniform insult to the skin, such as those who have undergone major surgical procedures.…”

Advances and future directions in keloid research: Pathogenesis, diagnosis and personalized treatment strategies

“…Over the years, considerable progress has been achieved by both researchers and clinicians in understanding the fundamental mechanisms of keloid formation and developing effective treatment options[ 6 ]. Advances in diagnostic imaging and molecular biology have improved our ability to identify and characterize keloids, while innovative therapeutic approaches, including laser therapy and cryotherapy, present promising alternatives to traditional surgical excision[ 7 - 10 ].…”