Ogawa Rei, Akaishi Satoshi, Kuribayashi Shigehiko, Miyashita Tsuguhiro
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School.
J Nippon Med Sch. 2016;83(2):46-53. doi: 10.1272/jnms.83.46.
Keloids and hypertrophic scars are fibroproliferative disorders of the skin that are caused by abnormal healing of injured or irritated skin. It is possible that they are both manifestations of the same fibroproliferative skin disorder and just differ in terms of the intensity and duration of inflammation. These features may in turn be influenced by genetic, systemic, and local risk factors. Genetic factors may include single nucleotide polymorphisms, while systemic factors may include hypertension, pregnancy, hormones, and cytokines. The most important local factor is tension on the scar. Over the past 10 years, our understanding of the pathogenesis of keloids and hypertrophic scars has improved markedly. As a result, these previously intractable scars are now regarded as being treatable. There are many therapeutic options, including surgery, radiation, corticosteroids, 5-fluorouracil, cryotherapy, laser therapy, anti-allergy agents, anti-inflammatory agents, bleaching creams and make-up therapies. However, at present, we believe that the following combination of three therapies most reliably achieves a complete cure: surgery, followed by radiation and the use of steroid tape/plaster.
瘢痕疙瘩和增生性瘢痕是皮肤的纤维增生性疾病，由受伤或受刺激皮肤的异常愈合引起。它们有可能是同一种纤维增生性皮肤病的不同表现，只是在炎症强度和持续时间方面有所不同。这些特征反过来可能受到遗传、全身和局部危险因素的影响。遗传因素可能包括单核苷酸多态性，而全身因素可能包括高血压、妊娠、激素和细胞因子。最重要的局部因素是瘢痕上的张力。在过去10年里，我们对瘢痕疙瘩和增生性瘢痕发病机制的理解有了显著提高。因此，这些以前难以治疗的瘢痕现在被认为是可治疗的。有许多治疗选择，包括手术、放疗、皮质类固醇、5-氟尿嘧啶、冷冻疗法、激光疗法、抗过敏剂、抗炎剂、美白霜和化妆疗法。然而，目前我们认为以下三种疗法的联合最可靠地实现了完全治愈：手术，随后放疗以及使用类固醇胶带/膏药。
