The Vascular Architecture of the Keloid: A Scanning Electron Microscope Study on Vascular Corrosion Casts

Lametschwandtner, Alois; Staindl, O.

doi:10.1007/978-3-642-77882-7_12

Cited by 5 publications

(4 citation statements)

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“…In addition, tissues have increased VEGF levels and vessels, as observed with immunohistochemical staining 15 . Histologically, keloids have a typical pattern of dispersed, extended vessels 7 , and subepidermal vessels with luminal bulging of the endothelial lining are conspicuous on electron microscopy 16 . Therefore, vessels located just under the epidermis are brought into sharp focus by using dermoscopy, which allows the visualization of their bright red color like that of arborizing vessels 8 .…”

Section: Discussionmentioning

confidence: 99%

Keloids and Hypertrophic Scars: Characteristic Vascular Structures Visualized by Using Dermoscopy

Yoo

Kim

2014

Ann Dermatol

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BackgroundKeloids 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.ObjectiveThis study investigated the clinical and dermoscopic features of keloids and hypertrophic scars in order to help dermatologists distinguish these lesions better.MethodsA 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.ResultsDermoscopy 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).ConclusionA 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.

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Section: Discussionmentioning

confidence: 99%

Keloids and Hypertrophic Scars: Characteristic Vascular Structures Visualized by Using Dermoscopy

Yoo

Kim

2014

Ann Dermatol

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“…18 In 1990, Lametschwandtner applied this technique to cast selected areas of the microvascular bed in human cadavers. 19,20 This technique allowed a less time-consuming, highly efficient investigation of the distribution and morphology of MVVs (Figs. 3 and 4).…”

Section: Historical Introductionmentioning

confidence: 99%

Valves in Small Veins and Venules

Caggiati

Phillips

Lametschwandtner

et al. 2006

European Journal of Vascular and Endovascular Surgery

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It is commonly believed that valves are absent in veins smaller than two millimetres in diameter. Consequently, current investigations on the pathophysiology of chronic venous disease (CVD) consider and evaluate only the valvular competence of large veins. The authors review literature from their own collections as well as from medical database searches to assess the functional relevance of these valves. Microscopic venous valves (MVVs) were first described in 1934 in the human digits and have subsequently been demonstrated in other parts of the human body as well as in many tissues and organs of animals. Their location and arrangement suggests that MVVs prevent blood reflux in small sized veins and restrict flow from postcapillary venules back into the capillary bed. This haemodynamic role of MVVs is strongly supported by the clinical finding that grafting skin rich in MVVs results in long-lasting healing leg ulcers attributable to CVD. The huge body of knowledge available concerning MVVs urges us to correct textbooks of anatomy. Studies on the pathophysiology of CVI should acknowledge that the valvular "chain" is not limited to large veins, but extends down to the venular level where MVVs play an important role in venous haemodynamics.

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“…6 Under an electron microscope, marked bulging of the endothelial lining into vascular lumens was visible in keloids. 9 The second cause is the intense proliferation of fibroblasts.…”

Section: Vascular Structure Of Pathological Scarsmentioning

confidence: 99%

The Characteristics of Blood Supply and Tissue Hypoxia in Pathological Scars

李梓菲¹,

Li²,

刘清亮³

et al. 2017

Chinese Medical Sciences Journal

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Blood supply is believed to be an important aspect in the development of pathological scars. However, there are controversies about vascular distribution, vascular structure and blood flow in pathological scars. Additionally, hypoxic microenvironment plays an important role in the vascularization of pathological scar tissues, and hypoxic conditions can be reflected by metabolic indexes and some cytokines. Furthermore, the correlation between blood supply and tissue hypoxia is controversial. The aim of this article is to review the literature on the characteristics of blood supply and tissue hypoxia in pathological scars, from which we can see pathological scars have unique characteristics of blood supply that are closely associated with tissue hypoxia. Moreover, development in the treatment of pathological scars is herein reviewed.Chin Med Sci J 2017; 32(2):113-118. DOI:10.24920/J1001-9294.2017.014 ATHOLOGICAL scars include hypertrophic scar and keloid. They influence appearance and even cause functional disturbance, and place tremendous physiological and psychological burdens on patients. Therefore, pathological scars have been a challenge in plastic surgery and the focus of research.Blood supply is believed to be an important aspect in the development of pathological scars, and has thus attracted more attentions in recent years. However, there are controversies about blood supply in pathological scars.Hereby we summarized the advances of research on the blood supply in pathological scars, and explored future research directions. The vascular structure of pathological scars has different manifestations between hypertrophic scars and keloids. In terms of spatial vascular structure, blood vessels within hypertrophic scar tissues have a structure perpendicular to the skin surface, whereas those within keloid tissues present a typical dispersed, extended vascular structure. VASCULARITY OF PATHOLOGICAL SCARS 5,6The diameter or patency of the blood vessels of pathological scar remains controversial. Thaís et al used stereological methods to obtain information on pathological scar tissues with a microscope, and proposed that the blood vessels within the pathological scars were dilated compared with those in normal skin and normal scars.

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The Vascular Architecture of the Keloid: A Scanning Electron Microscope Study on Vascular Corrosion Casts

Cited by 5 publications

References 5 publications

Keloids and Hypertrophic Scars: Characteristic Vascular Structures Visualized by Using Dermoscopy

Keloids and Hypertrophic Scars: Characteristic Vascular Structures Visualized by Using Dermoscopy

Valves in Small Veins and Venules

The Characteristics of Blood Supply and Tissue Hypoxia in Pathological Scars

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