Yoo Min Gun, Kim Il-Hwan
Department of Dermatology, Korea University College of Medicine, Seoul, Korea.
Ann Dermatol. 2014 Oct;26(5):603-9. doi: 10.5021/ad.2014.26.5.603. Epub 2014 Sep 26.
Keloids and hypertrophic scars represent excessive scarring. They require different therapeutic approaches, which can be hampered because of an apparent lack of morphologic difference between the two diseases.
This study investigated the clinical and dermoscopic features of keloids and hypertrophic scars in order to help dermatologists distinguish these lesions better.
A total of 41 keloids and hypertrophic scars in 41 patients were examined clinically and by performing dermoscopy with a digital imaging system. Lesions were evaluated for vascular structures.
Dermoscopy revealed vascular structures in most keloid lesions (90%) but in only 27% of hypertrophic scar lesions. The most common dermoscopic vascular structures in keloids were arborizing (52%), followed by linear irregular (33%) and commashaped (15%); these features were present but less evident in hypertrophic scars (9% for all types). The distribution frequency of the vascular structures differed significantly between diseases (p<0.001).
A strong association of vascular structures with keloids was observed on dermoscopic examination. The results suggest dermoscopic examination of vascular structures is a clinically useful diagnostic tool for differentiating between keloids and hypertrophic scars.
瘢痕疙瘩和增生性瘢痕表现为过度瘢痕形成。它们需要不同的治疗方法，但由于这两种疾病在形态学上明显缺乏差异，可能会阻碍治疗。
本研究调查瘢痕疙瘩和增生性瘢痕的临床和皮肤镜特征，以帮助皮肤科医生更好地区分这些病变。
对41例患者的41个瘢痕疙瘩和增生性瘢痕进行临床检查，并使用数字成像系统进行皮肤镜检查。评估病变的血管结构。
皮肤镜检查显示，大多数瘢痕疙瘩病变（90%）有血管结构，而增生性瘢痕病变中只有27%有血管结构。瘢痕疙瘩中最常见的皮肤镜血管结构是树枝状（52%），其次是线性不规则状（33%）和逗号状（15%）；这些特征在增生性瘢痕中也存在，但不太明显（所有类型均为9%）。两种疾病的血管结构分布频率差异有统计学意义（p<0.001）。
皮肤镜检查发现血管结构与瘢痕疙瘩密切相关。结果表明，对血管结构进行皮肤镜检查是区分瘢痕疙瘩和增生性瘢痕的一种临床有用的诊断工具。
