Papers of The 7th Japan Scar Workshop

1. Bibliographic and Empirical Consideration about Genetic, Systemic, and Local Factors of the Pathogenesis of Keloids and Hypertrophic Scars

Rei Ogawa, Satoshi Akaishi, Hiko Hyakusoku
Department of Plastic, Reconstructive and Aesthetic Surgery, Nippon Medical School, Tokyo, Japan

Keloids and hypertrophic scars are fibroproliferative disorders (FPD) of the skin. Analysis of the literature suggests that it is reasonable to regard keloids and hypertrophic scars as multifactorial disorders, namely, disorders that are driven by an underlying genetic propensity whose expression is strongly influenced by systemic factors and local wound conditions. In other words, it may be the balance between genetic, systemic and local factors that determines the fate of a wound, namely, whether it becomes a keloid, a hypertrophic scar, or a normal scar. Thus, we would like to propose a model that represents the balance between the factors. For genetic factors, SNPs can be considered. Soluble factors including cytokines and hormones, various cells that are influenced by inflammation, and hypertension can be considered as systemic factors. Moreover, it has been suggested that mechanical forces are important as a local factor to produce keloids and hypertrophic scars.
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