Papers of The 3rd Japan Scar Workshop

16. Histological Analysis of Mature Scars, Hypertrophic Scars, and Keloids

Miki Izumi1, Akira Sugamata2, Satoshi Akaishi3, Rei Ogawa3,
Hiko Hyakusoku3

1:Department of Pathology, Tokyo Medical University
2:Plastic and Reconstructive Surgery of Tokyo Medical University Hachioji Medical Center
3:Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School Hospital

With regard to the differential diagnosis between keloids and hypertrophic scars (HSs), while many traditional textbooks of pathology treat keloids and HSs as completely different types of scars, we have encountered cases in our clinic where the scar bore features of both keloids and HSs. Thus, we reattempted to study the histological features of keloids.
Four typical keloids that were resected by surgery were used for this study. Specimens were stained with HE and analyzed. Typical pathological features of mature scars, HSs and keloids were observed in every specimen. Reticular dermis changed to scars, and contained significantly higher numbers of macrophages, lymphocytes, and mast cells and higher proportions of the subpopulations compared to normal skin.
The above findings suggest that histological features of mature scars, HSs and keloids can be observed in keloids at any time, and that these features are gradable and thus many intermediate stages may exist. Careful observation may show that these features differ in degree between keloids and HSs.
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