Search Results (60)

Background: The consequences of injuries resulting from accidents are among the most common health disorders in children. A scar forms at the site of the injury. In the treatment of scars, not all methods used in adults can be used in children. The authors attempted to assess the effectiveness of using KT kinesiology taping on scars in children. The aim of the work is to assess the effect of KT on the treatment of keloid, hypertrophic scars, and postoperative adhesions in children. Methods: The study included 30 patients aged 4 to 10 years. The subjects were divided into three groups: group G1-9 patients with keloid scars, group G2-14 with hypertrophic scars, group G3-7 with postoperative adhesions. The patients underwent kinesiology taping for 8 weeks. The analyzed parameters were determined using the VSS scale and ultrasonography. Results: The analysis of the VSS scale results in relation to the type of scars showed a significant (p < 0.001) downward trend in the measured parameters for keloid and hypertrophic scars. Analysis of ultrasound results in relation to the type of scars showed a significant (p < 0.001) downward trend in the measured parameters, comparing parameters I and II for all types of scars. Conclusions: Kinesiology taping significantly changes the following scar parameters: deformability, pigmentation, and perfusion in the case of keloid and hypertrophic scars. Full article

Background/Objectives: Keloid treatment remains challenging due to limited effectiveness and patient dissatisfaction. Herbal-based therapy offers promising alternatives that require further investigation. Uncaria gambir (W.Hunter) Roxb., an original plant from Indonesia, possesses an antifibrotic effect. However, its potential as an antifibrotic agent in keloid management remains unclear. This study aims to bridge this gap by evaluating the bioactive compound from gambir and its effects on keloid fibroblast primary culture. Methods: The bioactive compounds of gambir extract and fractions (ethanol, hexane, and ethyl acetate fractions) were identified by using liquid chromatography–mass spectrometry (LCMS/MS) analysis. The mechanism of gambir bioactive compounds for keloid was predicted using the compound–protein interaction network and enrichment analysis, and validated using molecular docking and dynamic simulation. The experimental study results, including cytotoxic and bioactivity effects, were represented as IC₅₀ and selectivity index (SI) values, and the ex vivo analysis of keloid tissue explants. Results: Uncariagambiriine was identified as the most potent compound with the lowest binding energy and high stability to the core protein targets: AKT1 and TGFB1. The ethanol fraction was determined to have the highest abundance of gambir’s typical bioactive compounds, with the lowest IC₅₀ (128.76 ± 0.24 µg/mL) and the highest SI (6.32) value. Furthermore, the results of the ex vivo analysis indicated the significant inhibition of keloid fibroblast proliferation and migration by the gambir ethanolic fraction. Conclusions: This study underlines the potential of the gambir ethanolic fraction as an antifibrotic agent in keloid, warranting further investigation and development for clinical applications. Full article

The cicatrization process, which is critical to equine health, directly affects overall well-being by preventing infection, minimizing tissue damage, and restoring optimal function. Herein, we present a case of a 5-year-old sorrel mare with a torn skin wound on the dorsal aspect of the metatarsal region of the left hind limb, treated locally with an antibiotic-free transparent hydrogel-based patch while monitoring its healing process. The patch induced pink granulation tissue in the treated area after 42 days, while keloid formation was observed in the untreated area. Wound measurements showed a reduction over time with patch treatment, with complete healing achieved at 116 days. Capillary formation and a velvety appearance were observed on day 80. Histological analysis revealed mature granulation tissue, fibrocyte formation, abundant capillaries, organized collagen fibrils, and development of type III collagen in the treated area. Interestingly, no inflammatory response was observed during treatment. The hydrogel patch not only accelerated healing, but also controlled excessive granulation tissue formation. This treatment represents an innovative approach to equine wound management that updates applications for owners while reducing costs. Full article

Background and Objectives: Pediatric patients can acquire scars from both accidental injury and surgical procedures. While scars cannot be avoided if a full-thickness injury occurs, scar visibility may be minimized through a variety of approaches. In this narrative review, we evaluate the current evidence and propose an algorithm for scar management in pediatric patients. Materials and Methods: A review of the literature was performed for scar management techniques for pediatric patients. Management modalities based on the type of scar and dosing, treatment regimen, and safety profiles are described in this article and used to create a scar management algorithm. Results: The initial step to scar management in the pediatric population involves ensuring minimal wound tension, which can be achieved through making the incision along relaxed skin tension lines, and early, minimal tension wound closure. Subsequent treatments to optimize scar care should begin 2–3 weeks following wound closure and involve the application of silicone gel or sheets and scar massaging. When topical products are insufficient, laser therapy can be utilized for the management of immature erythematous or thick scars. When mature, pathological scars form such as atrophic scars, hyperpigmentation, hypertrophic scars, or keloids, a combination of modalities is recommended. These modalities vary by scar type and include retinoids and dermabrasion for atrophic scars; retinoids, hydroquinone, and laser therapy for hyperpigmentation; and pressure therapy, corticosteroids, and laser therapy for hypertrophic scars and keloids. When mature, pathological scars persist following 12 months of non-invasive therapies, surgical excision should be considered. Conclusions: Several treatment options are available to manage scars in the pediatric population depending on scar type. Full article

Background/Objectives: Misdiagnosing skin disorders leads to the administration of wrong treatments, sometimes with life-impacting consequences. Deep learning algorithms are becoming more and more used for diagnosis. While many skin cancer/lesion image classification studies focus on datasets containing dermatoscopic images and do not include keloid images, in this study, we focus on diagnosing keloid disorders amongst other skin lesions and combine two publicly available datasets containing non-dermatoscopic images: one dataset with keloid images and one with images of other various benign and malignant skin lesions (melanoma, basal cell carcinoma, squamous cell carcinoma, actinic keratosis, seborrheic keratosis, and nevus). Methods: Different Convolution Neural Network (CNN) models are used to classify these disorders as either malignant or benign, to differentiate keloids amongst different benign skin disorders, and furthermore to differentiate keloids among other similar-looking malignant lesions. To this end, we use the transfer learning technique applied to nine different base models: the VGG16, MobileNet, InceptionV3, DenseNet121, EfficientNetB0, Xception, InceptionRNV2, EfficientNetV2L, and NASNetLarge. We explore and compare the results of these models using performance metrics such as accuracy, precision, recall, F1_score, and AUC-ROC. Results: We show that the VGG16 model (after fine-tuning) performs the best in classifying keloid images among other benign and malignant skin lesion images, with the following keloid class performance: an accuracy of 0.985, precision of 1.0, recall of 0.857, F1 score of 0.922 and AUC-ROC value of 0.996. VGG16 also has the best overall average performance (over all classes) in terms of the AUC-ROC and the other performance metrics. Using this model, we further attempt to predict the identification of three new non-dermatoscopic anonymised clinical images, classifying them as either malignant, benign, or keloid, and in the process, we identify some issues related to the collection and processing of such images. Finally, we also show that the DenseNet121 model has the best performance when differentiating keloids from other malignant disorders that have similar clinical presentations. Conclusions: The study emphasised the potential use of deep learning algorithms (and their drawbacks), to identify and classify benign skin disorders such as keloids, which are not usually investigated via these approaches (as opposed to cancers), mainly due to lack of available data. Full article

Background/Objectives: Hydrocolloid dressings are commonly used in the treatment of chronic wounds by forming a gel-like protective layer upon the dispersion of water, absorbing exudate, and creating a moist environment that promotes healing. However, the use of hydrocolloids has expanded outside of wound care, and this review summarizes the evidence for their use within dermatology. Methods: To perform this narrative review, several databases were searched for manuscripts that described the use of hydrocolloid dressings within dermatology. Results: The hydrophilic and colloidal dispersion properties of hydrocolloid dressings facilitate the formation of an absorptive, hydrating, and protective layer. In addition, the viscous layer supports innate immunity by activating immune cells such as granulocytes and monocytes, making them effective in wound care. Hydrocolloid dressings appear to be an effective treatment in acute wounds, with the potential of reduced healing time and easier application compared to traditional dressings. The majority of the related research suggests that hydrocolloid dressings and standard dressings have similar efficacy in healing pressure ulcers, and the prevention of hypertrophic and keloid scars. Early reports suggest that hydrocolloid dressings have a role in the treatment of facial dermatitis and acne vulgaris. Conclusions: Hydrocolloid dressings have been studied most extensively for chronic wounds and then for use in acute wounds. There have been a few studies on their use for treating acne, facial atopic dermatitis, and hypertrophic scarring. While more clinical studies are needed, there appears to be early evidence of hydrocolloid dressing use within dermatology. Full article

Cosmetic dermatology increasingly utilizes laser technologies to address various aesthetic concerns. This study evaluates the efficacy of the flash-lamp pulsed-dye laser (FPDL) in treating vascular and scar-related conditions. A cohort of 71 patients with diverse vascular lesions, including facial telangiectasia, port-wine stains (PWSs), striae rubrae, erythematous acne scars, facial traumatic scars, and keloids, was treated using the FPDL (Synchro Vas-Q, Deka MELA). Treatment protocols varied based on lesion type, with sessions ranging from one to eight at intervals of four to eight weeks. Clinical outcomes were assessed using a four-point grading scale and patient satisfaction surveys. Results indicated that 70.4% of patients achieved excellent clearance of lesions, while 16.9% and 9.9% showed moderate-good and slight clearance, respectively. Minimal or no improvement was observed in 2.8% of cases. High patient satisfaction was reported, correlating with effective lesion reduction and manageable side effects, primarily post-operative purpura. The study underscores FPDL’s selective efficacy for hemoglobin-rich lesions and its safety profile, advocating for its continued use in cosmetic dermatological practices. These findings contribute to the growing evidence supporting laser therapy as a pivotal tool in aesthetic medicine, emphasizing the importance of tailored treatment protocols and patient education for optimal outcomes. Full article

Wound healing is a complex biological process that can lead to chronic wounds, keloids, and hypertrophic scars when disrupted. Chronic wounds result from a prolonged inflammatory phase and impaired re-epithelialization. Keloids are characterized by excessive collagen deposition beyond the original wound boundaries, driven by persistent inflammation and fibroblast hyperactivity. Hypertrophic scars, on the other hand, are confined to the wound edges and are caused by an imbalance in collagen synthesis and degradation, typically resolving over time. The therapeutic approach to wound healing impairment involves a range of strategies, including non-invasive (which focus on supporting the natural healing process), minimally invasive, and aggressive interventions (such as surgical approach, often reserved for severe or refractory cases). Emerging therapies, including stem cell treatments and botulinum toxin injections, offer new hope for improving outcomes in patients with wound healing impairments. This review highlights the distinct mechanisms underlying chronic wounds, keloids, and hypertrophic scars and discusses their respective therapeutic approaches, focusing on both established and emerging therapies. Understanding these mechanisms is crucial for optimizing treatment strategies and improving patient outcomes. Full article

Diagnosing solitary pink skin lesions poses a significant challenge due to the scarcity of specific clinical and dermoscopic criteria. Several benign lesions, such as cherry angioma, clear cell acanthoma, dermal nevus, keloid, hypertrophic scar, and Spitz nevus, often exhibit similar clinical and dermoscopic features. This similarity extends to some malignant lesions, including basal cell carcinoma, actinic keratosis, and amelanotic melanoma, making differentiation difficult. Recent studies highlight the enhanced diagnostic accuracy of reflectance confocal microscopy (RCM), which offers increased sensitivity and specificity compared to dermoscopy alone for diagnosing skin cancer. This study aims to summarize the application of dermoscopy and RCM in distinguishing between benign and malignant pinkish–reddish skin lesions. The integration of RCM with traditional dermoscopic techniques improves the ability to accurately identify and differentiate these lesions. However, it is crucial to note that for any suspicious lesions, a final diagnosis must be confirmed through surgical excision and histopathological evaluation. This comprehensive approach ensures accurate diagnosis and appropriate treatment, highlighting the importance of combining advanced imaging techniques in clinical practice. Full article

Keloid scars, characterized by abnormal fibroproliferation and excessive extracellular matrix (ECM) production that extends beyond the original wound, often cause pruritus, pain, and hyperpigmentation, significantly impacting the quality of life. Keloid pathogenesis is multifactorial, involving genetic predisposition, immune response dysregulation, and aberrant wound-healing processes. Central molecular pathways such as TGF-β/Smad and JAK/STAT are important in keloid formation by sustaining fibroblast activation and ECM deposition. Conventional treatments, including surgical excision, radiation, laser therapies, and intralesional injections, yield variable success but are limited by high recurrence rates and potential adverse effects. Emerging therapies targeting specific immune pathways, small molecule inhibitors, RNA interference, and mesenchymal stem cells show promise in disrupting the underlying mechanisms of keloid pathogenesis, potentially offering more effective and lasting treatment outcomes. Despite advancements, further research is essential to fully elucidate the precise mechanisms of keloid formation and to develop targeted therapies. Ongoing clinical trials and research efforts are vital for translating these scientific insights into practical treatments that can markedly enhance the quality of life for individuals affected by keloid scars. Full article

Keloids, marked by abnormal cellular proliferation and excessive extracellular matrix (ECM) accumulation, pose significant therapeutic challenges. Ethyl pyruvate (EP), an inhibitor of the high-mobility group box 1 (HMGB1) and TGF-β1 pathways, has emerged as a potential anti-fibrotic agent. Our research evaluated EP’s effects on keloid fibroblast (KF) proliferation and ECM production, employing both in vitro cell cultures and ex vivo patient-derived keloid spheroids. We also analyzed the expression levels of ECM components in keloid tissue spheroids treated with EP through immunohistochemistry. Findings revealed that EP treatment impedes the nuclear translocation of HMGB1 and diminishes KF proliferation. Additionally, EP significantly lowered mRNA and protein levels of collagen I and III by attenuating TGF-β1 and pSmad2/3 complex expression in both human dermal fibroblasts and KFs. Moreover, metalloproteinase I (MMP-1) and MMP-3 mRNA levels saw a notable increase following EP administration. In keloid spheroids, EP induced a dose-dependent reduction in ECM component expression. Immunohistochemical and western blot analyses confirmed significant declines in collagen I, collagen III, fibronectin, elastin, TGF-β, AKT, and ERK 1/2 expression levels. These outcomes underscore EP’s antifibrotic potential, suggesting its viability as a therapeutic approach for keloids. Full article

Nodular or keloidal scleroderma is a rare condition with unclear cause and sporadic mentions in the medical literature. It was first recognized in the 19th century, yet its classification is still debated due to the limited number of reported cases. This rare variant of scleroderma is associated with either progressive systemic sclerosis or localized morphea. Clinically, it presents with asymptomatic nodules or plaques, resembling spontaneous keloid formation, often found on the trunk and proximal extremities. Recent literature reviews show a predominance of women with a mean age of 44 years. Diagnosis relies on clinical and histopathological findings, which usually show overlapping features of both scleroderma and true keloids, secondarily to an excessive fibrosing reaction attributed to collagen formation. We present an unusual case of a 70-year-old female patient who displayed the coexistence of two distinct subtypes of morphea (nodular/keloidal and linear), and exclusive skin involvement, which contrasts with the typical presentation of nodular/keloidal scleroderma, often associated with organ-specific disease. However, recent publications have diverged from previous ones regarding systemic sclerosis, with no systemic involvement reported between 2018 and 2024, which we evaluated in our descriptive literature review. With less than 50 cases reported in total, our case underlines the importance of recognizing this rare disease, ensuring appropriate evaluation, treatment, and follow-up. Full article

Keloids (KD) and hypertrophic scars (HTS), which are quite raised and pigmented and have increased vascularization and cellularity, are formed due to the impaired healing process of cutaneous injuries in some individuals having family history and genetic factors. These scars decrease the quality of life (QOL) of patients greatly, due to the pain, itching, contracture, cosmetic problems, and so on, depending on the location of the scars. Treatment/prevention that will satisfy patients’ QOL is still under development. In this article, we review pharmacotherapy for treating KD and HTS, including the prevention of postsurgical recurrence (especially KD). Pharmacotherapy involves monotherapy using a single drug and combination pharmacotherapy using multiple drugs, where drugs are administered orally, topically and/or through intralesional injection. In addition, pharmacotherapy for KD/HTS is sometimes combined with surgical excision and/or with physical therapy such as cryotherapy, laser therapy, radiotherapy including brachytherapy, and silicone gel/sheeting. The results regarding the clinical effectiveness of each mono-pharmacotherapy for KD/HTS are not always consistent but rather scattered among researchers. Multimodal combination pharmacotherapy that targets multiple sites simultaneously is more effective than mono-pharmacotherapy. The literature was searched using PubMed, Google Scholar, and Online search engines. Full article

It is unclear whether normal human skin tissue or abnormal scarring are photoreceptive. Therefore, this study investigated photosensitivity in normal skin tissue and hypertrophic scars. The expression of opsins, which are photoreceptor proteins, in normal dermal fibroblasts (NDFs) and hypertrophic scar fibroblasts (HSFs) was examined. After exposure to blue light (BL), changes in the expression levels of αSMA and clock-related genes, specifically PER2 and BMAL1, were examined in both fibroblast types. Opsins were expressed in both fibroblast types, with OPN3 exhibiting the highest expression levels. After peripheral circadian rhythm disruption, BL induced rhythm formation in NDFs. In contrast, although HSFs showed changes in clock-related gene expression levels, no distinct rhythm formation was observed. The expression level of αSMA was significantly higher in HSFs and decreased to the same level as that in NDFs upon BL exposure. When OPN3 knocked-down HSFs were exposed to BL, the reduction in αSMA expression was inhibited. This study showed that BL exposure directly triggers peripheral circadian synchronization in NDFs but not in HSFs. OPN3-mediated BL exposure inhibited HSFs. Although the current results did not elucidate the relationship between peripheral circadian rhythms and hypertrophic scars, they show that BL can be applied for the prevention and treatment of hypertrophic scars and keloids. Full article

There are three known clinical syndromes of leishmaniasis: cutaneous (CL), mucocutaneous (MCL), and visceral disease (VL). In MCL and VL, treatment must be systemic (either oral or intravenous), while CL treatment options vary and include observation-only localized/topical treatment, oral medications, or parenteral drugs. Leishmaniasis treatment is difficult, with several factors to be considered. First, the efficacy of treatments varies among different species of parasites prevalent in different areas on the globe, with each species having a unique clinical presentation and resistance profile. Furthermore, leishmaniasis is a neglected tropical disease (NTD), resulting in a lack of evidence-based knowledge regarding treatment. Therefore, physicians often rely on case reports or case series studies, in the absence of randomized controlled trials (RCT), to assess treatment efficacy. Second, defining cure, especially in CL and MCL, may be difficult, as death of the parasite can be achieved in most cases, while the aesthetic result (e.g., scars) is hard to predict. This is a result of the biological nature of the disease, often diagnosed late in the course of disease (with possible keloid formation, etc.). Third, physicians must consider treatment ease of use and the safety profile of possible treatments. Thus, topical or oral treatments (for CL) are desirable and promote adherence. Fourth, the cost of the treatment is an important consideration. In this review, we aim to describe the diverse treatment options for different clinical manifestations of leishmaniasis. For each currently available treatment, we will discuss the various considerations mentioned above (efficacy, ease of use, safety, and cost). Full article