Department of Plastic Surgery, Keio University, Tokyo, Japan.
Med Hypotheses. 2013 Jul;81(1):136-41. doi: 10.1016/j.mehy.2013.04.016. Epub 2013 Apr 30.
Keloids gradually change their shapes as they grow. We hypothesize that the change of keloid morphology reflects the incremental change of the stress patterns occurring in peri-keloid regions due to movement of the keloid-carrying body part. To examine the validity of this hypothesis, we used three-dimensional finite element analysis to calculate the stresses occurring in the peri-keloid regions of keloids on the chest in response to respiratory movement. The stresses concentrate at the peri-keloid regions close to the bilateral ends of the keloids. By reviewing this result in reference to our hypothesis, we can explain why keloids on the chest are likely to present crab or butterfly shapes. Although we know that keloids grow in response to mechanical stresses, our hypothesis differs from existing ones in that it focuses on morphological transformation. Our hypothesis is helpful for physicians in performing treatment for keloids, because they can predict what part of a keloid is likely to grow and perform preventive treatment in reference to the hypothesis.
瘢痕疙瘩在生长过程中会逐渐改变形状。我们假设瘢痕形态的变化反映了由于携带瘢痕的身体部位的运动，瘢痕周围区域的应力模式的增量变化。为了检验这一假设的有效性，我们使用三维有限元分析计算了胸部瘢痕周围区域在呼吸运动时发生的应力。这些应力集中在瘢痕周围区域靠近瘢痕两侧的部位。通过参考我们的假设来审查这一结果，我们可以解释为什么胸部的瘢痕可能呈现出蟹形或蝶形。尽管我们知道瘢痕是对机械应力的反应而生长的，但我们的假设与现有的假设不同，因为它侧重于形态变化。我们的假设有助于医生对瘢痕进行治疗，因为他们可以根据假设预测瘢痕的哪个部位可能会生长，并进行预防性治疗。
