Papers of The 1st Japan Scar Workshop

12. The Study of Inflammatory Cells on Redness Sites of Keloids

Hattori N, Takano J, Kishi K, Nakajima T
Department of Plastic Surgery, Keio University, Tokyo, Japan

BACKGROUND: The important difference between keloids and hypertrophic scars is that the former invade normal skin whereas the latter do not. Before keloids invade normal skin, causing it to bulge, patients complain of redness and itching, resembling the symptoms of dermatitis. The aim of our study was to investigate the characteristic inflammatory cell subpopulations in the area of redness around keloids. METHODS: We investigated the distribution of lymphocytes and macrophages among 4 groups: keloids (center sites and redness sites), hypertrophic scars, and normal skin. All tissues were fixed with formalin and embedded in paraffin. Hematoxylin and eosin, Elastica van Gieson, and toluidine blue stains were utilized for routine histological examination. In addition, sections were stained with anti-inflammatory cell monoclonal antibodies. The numbers of lymphocytes, macrophages, and mast cells were compared. RESULTS: We found significantly larger numbers of inflammatory cells (lymphocytes and macrophages) and a higher CD4+:CD8+ ratio in the center sites of keloids, redness sites of keloids, and hypertrophic scars versus normal skin. Inflammation had already occurred in the redened sites of keloids, as in their center sites. CONCLUSION: The results suggest that it may be possible to prevent the invasion of keloids by controlling inflammation at the sites of redness.
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