Choi Young-Hee, Kim Kwang-Min, Kim Hye-One, Jang Young-Chul, Kwak In-Suk
Department of Pathology, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Ann Dermatol. 2013 Nov;25(4):428-33. doi: 10.5021/ad.2013.25.4.428. Epub 2013 Nov 30.
Hypertrophic scar following a burn is caused by the excessive deposit of collagen resulting in an exaggerated wound healing response. The burn patient complains of pain and itching over the scar, which can give rise to cosmetic and functional problems.
The aim of this study was to investigate the clinical and histological correlation of a hypertrophic burn scar for itching and pain sensations.
Thirty-eight patients underwent a scar release and skin graft. the modified Vancouver scar scale and the verbal numerical rating scale were recorded. All biopsies were taken from scar tissue (scar) and normal tissue (normal). Histologically, tissues were observed in the epidermis, the monocytes around the vessels, the collagen fiber, elastic fiber, and the mast cells.
The mean total score of MVSS was 8.4±2.7 (pliability 2.0±0.9; thickness 1.8±0.9; vascularity 2.0± 0.9; and pigmentation 2.1±0.9). Pain and itching were 2.4±2.0 and 2.9±3.0. Epidermis were 7.9±2.8 layers (scar) and 4.0±0.8 layers (normal). The collagen fibers were thin and dense (scar) and thicker and loose (normal). The elastic fibers were thin and nonexistent (scar) and thin and loose (normal). Mast cells were 11.2±5.8/high power field (scar) and 7.4±4.1 (normal).
As the scar tissue thickens, the itching becomes more severe. The stiffness of the scar with the pain appeared to be associated with the condition of the tissue. The correlation between clinical and histological post-burn hypertrophic scars will help further studies on the scar. This helped with the development of the base material for therapeutic strategies.
烧伤后增生性瘢痕是由胶原蛋白过度沉积导致伤口愈合反应过度引起的。烧伤患者会抱怨瘢痕处疼痛和瘙痒，这可能会引发美观和功能问题。
本研究旨在探讨增生性烧伤瘢痕瘙痒和疼痛感觉的临床与组织学相关性。
38例患者接受了瘢痕松解和皮肤移植。记录改良温哥华瘢痕量表和言语数字评定量表。所有活检均取自瘢痕组织（瘢痕）和正常组织（正常）。组织学上，观察表皮、血管周围的单核细胞、胶原纤维、弹性纤维和肥大细胞。
MVSS的平均总分是8.4±2.7（柔韧性2.0±0.9；厚度1.8±0.9；血管分布2.0±0.9；色素沉着2.1±0.9）。疼痛和瘙痒分别为2.4±2.0和2.9±3.0。表皮在瘢痕处为7.9±2.8层，在正常处为4.0±0.8层。胶原纤维在瘢痕处细而致密，在正常处粗而疏松。弹性纤维在瘢痕处细且不存在，在正常处细且疏松。肥大细胞在瘢痕处为11.2±5.8/高倍视野，在正常处为7.4±4.1。
随着瘢痕组织增厚，瘙痒变得更严重。瘢痕的硬度与疼痛似乎与组织状况有关。烧伤后增生性瘢痕的临床与组织学相关性将有助于对瘢痕的进一步研究。这有助于治疗策略基础材料的开发。
