Naylor Michelle C, Brissett Anthony E
Bobby R. Alford Department of Otolaryngology-Head and Neck Surgery, Baylor College of Medicine, Houston, Texas, USA.
Facial Plast Surg. 2012 Oct;28(5):504-12. doi: 10.1055/s-0032-1325644. Epub 2012 Oct 1.
Keloids are benign, fibroproliferative growths that occur as a result of dermal injury in ~15% of the population. They are characterized by their extension beyond the confines of the original injury and often present with pain and pruritus. Additionally, these growths may result in cosmetic deformities and contribute to significant emotional distress. It is thought that keloids form as a result of aberrancies in the normal wound-healing process, which is complex and involves an elegant interplay between multiple cell types, cytokines, and proteins. The exact etiology is unknown, but significant research efforts have been made. These efforts have revealed that various cell types in keloids are either hyperresponsive and/or overproductive of various growth factors. Additionally, keloid cell types respond differently to mechanical strain than skin cells in patients who do not form keloids. This lack of understanding of keloid pathophysiology has left the care provider with a lack of a single definitive treatment strategy. Instead, a multitude of therapies exist ranging from surgery to injectables to lasers and any combination thereof. This purpose of this article is to highlight our current knowledge and emerging scientific understanding of keloid pathology and the current management strategies.
瘢痕疙瘩是一种良性纤维增生性肿物，约15%的人群在皮肤损伤后会出现。其特点是超出原始损伤范围生长，常伴有疼痛和瘙痒。此外，这些肿物可能导致美容缺陷，并造成严重的情绪困扰。人们认为瘢痕疙瘩是正常伤口愈合过程异常所致，该过程复杂，涉及多种细胞类型、细胞因子和蛋白质之间的精妙相互作用。确切病因尚不清楚，但已开展了大量研究工作。这些研究表明，瘢痕疙瘩中的各种细胞类型对各种生长因子反应过度和/或产生过多。此外，与不形成瘢痕疙瘩的患者相比，瘢痕疙瘩细胞类型对机械应变的反应不同。对瘢痕疙瘩病理生理学的这种缺乏了解，使得医疗服务提供者缺乏单一的明确治疗策略。相反，存在多种治疗方法，从手术到注射剂再到激光以及它们的任何组合。本文的目的是强调我们目前对瘢痕疙瘩病理学的认识以及新出现的科学理解，以及当前的管理策略。
