Al-Attar Ali, Mess Sarah, Thomassen John Michael, Kauffman C Lisa, Davison Steven P
Division of Dermatology, Department of Plastic Surgery, Georgetown University Medical Center, Washington, DC 20007, USA.
Plast Reconstr Surg. 2006 Jan;117(1):286-300. doi: 10.1097/01.prs.0000195073.73580.46.
Keloid management can be difficult and frustrating, and the mechanisms underlying keloid formation are only partially understood.
Using original and current literature in this field, this comprehensive review presents the major concepts of keloid pathogenesis and the treatment options stemming from them.
Mechanisms for keloid formation include alterations in growth factors, collagen turnover, tension alignment, and genetic and immunologic contributions. Treatment strategies for keloids include established (e.g., surgery, steroid, radiation) and experimental (e.g., interferon, 5-fluorouracil, retinoid) regimens.
The scientific basis and empiric evidence supporting the use of various agents is presented. Combination therapy, using surgical excision followed by intradermal steroid or other adjuvant therapy, currently appears to be the most efficacious and safe current regimen for keloid management.
瘢痕疙瘩的治疗可能困难且令人沮丧，瘢痕疙瘩形成的潜在机制仅得到部分理解。
利用该领域的原始文献和当前文献，本综述呈现了瘢痕疙瘩发病机制的主要概念以及由此产生的治疗选择。
瘢痕疙瘩形成的机制包括生长因子的改变、胶原蛋白更新、张力排列以及遗传和免疫因素。瘢痕疙瘩的治疗策略包括既定方法（如手术、类固醇、放疗）和实验性方法（如干扰素、5-氟尿嘧啶、维甲酸）。
阐述了支持使用各种药物的科学依据和经验证据。目前，采用手术切除后皮内注射类固醇或其他辅助治疗的联合疗法似乎是治疗瘢痕疙瘩最有效且安全的现行方案。
