Park Tae Hwan, Park Ji Hae, Tirgan Michael H, Halim Ahmad Sukari, Chang Choong Hyun
From the *Department of Plastic and Reconstructive Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea; †Keloid Research Foundation, New York, NY; and ‡Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia.
Ann Plast Surg. 2015 Feb;74(2):248-51. doi: 10.1097/SAP.0b013e3182a2b537.
There is strong evidence of genetic susceptibility in individuals with keloid disorder. The purpose of this cross-sectional study was to determine the clinical relevance of our proposed variables on the multiplicity of keloids by further investigating the presence of other keloids and a family history.
This was a retrospective review, using institutional review board-approved questionnaires, of patients with keloids who were seen at Kangbuk Samsung Hospital between December 2002 and February 2010. Eight hundred sixty-eight patients were included in our study. Comparisons between the 2 groups were made using Mann-Whitney tests for continuous variables and χ2 tests for categorical variables.
In our patient group, younger age of onset and the presence of family history were significantly associated with the occurrence of keloids at multiple sites. The locations of extra-auricular keloids, in order of frequency, included the shoulder; anterior chest, including the breasts; deltoid; trunk and pubic area; upper extremities; lower extremities; and other sites. As compared to secondary keloids, primary keloids were significantly associated with both a lower degree of recurrence and the presence of other keloids. The presence or absence of family history was significantly associated with the presence or absence of other keloids and primary or secondary keloids.
Keloid disorder is one of the most frustrating problems in wound healing and advances in our understanding of the differences of occurrence at a single site versus multiple sites might help in understanding pathogenesis and improving treatment.
有充分证据表明瘢痕疙瘩患者存在遗传易感性。这项横断面研究的目的是通过进一步调查其他瘢痕疙瘩的存在情况和家族史,来确定我们提出的变量对瘢痕疙瘩多发性的临床相关性。
这是一项回顾性研究,使用经机构审查委员会批准的问卷,对2002年12月至2010年2月在江北三星医院就诊的瘢痕疙瘩患者进行调查。我们的研究纳入了868例患者。连续变量采用Mann-Whitney检验,分类变量采用χ2检验进行两组间比较。
在我们的患者组中,发病年龄较小和有家族史与多处出现瘢痕疙瘩显著相关。耳外瘢痕疙瘩的部位按频率依次为肩部;前胸,包括乳房;三角肌;躯干和耻骨区;上肢;下肢;以及其他部位。与继发性瘢痕疙瘩相比,原发性瘢痕疙瘩与较低的复发率和其他瘢痕疙瘩的存在均显著相关。家族史的有无与其他瘢痕疙瘩的有无以及原发性或继发性瘢痕疙瘩显著相关。
瘢痕疙瘩是伤口愈合中最令人沮丧的问题之一,深入了解单处与多处发病差异可能有助于理解发病机制并改善治疗。