Thomas Asia, Farah Kanith, Millis Richard M
Pathophysiology, American University of Antigua, Coolidge, ATG.
Cureus. 2022 Mar 26;14(3):e23503. doi: 10.7759/cureus.23503. eCollection 2022 Mar.
Primary care physicians and dermatologists are challenged by patients affected by keloid or hypertrophic scarring resulting from accidental wounding, surgical incisions, tattooing, or "branding" procedures to demonstrate their association with a specific culture, fraternity, or cult. The dysregulated wound healing associated with keloids and hypertrophic scarring adversely affects genetically susceptible individuals, especially persons of color with Fitzpatrick Skin types IV-VI. Although the specific mechanisms of bulky hypertrophic/keloid scarring and its association with oxidative stress and inflammation remain unclear, the current knowledge base is sufficient to provide some guidance to health practitioners who must serve, treat, and counsel affected individuals. This review focuses on providing insight to healthcare professionals about the role of epigenetics, oxidative stress, poor local oxygenation, and its relationship to impaired wound healing. The goal is to promote further research on bulky hypertrophic and keloid scarring for its prevention and to develop evidence-based clinical guidelines for optimal treatment.
原发性保健医生和皮肤科医生面临着挑战，因为那些因意外受伤、手术切口、纹身或“烙印”程序而出现瘢痕疙瘩或增生性瘢痕的患者，会试图证明这些瘢痕与特定文化、兄弟会或邪教有关联。与瘢痕疙瘩和增生性瘢痕相关的伤口愈合失调，对基因易感性个体产生不利影响，尤其是皮肤菲茨帕特里克分型为IV - VI型的有色人种。尽管巨大增生性/瘢痕疙瘩性瘢痕的具体机制及其与氧化应激和炎症的关联仍不清楚，但目前的知识库足以给那些必须为受影响个体提供服务、治疗和咨询的医疗从业者提供一些指导。本综述旨在为医疗保健专业人员提供关于表观遗传学、氧化应激、局部氧合不良的作用及其与伤口愈合受损关系的见解。目标是推动对巨大增生性和瘢痕疙瘩性瘢痕预防的进一步研究，并制定基于证据的最佳治疗临床指南。
