title: Dermabrasive scar revision. Immunohistochemical and ultrastructural evaluation.
abstract: BACKGROUND
  Dermabrasion of facial scars 4-8 weeks after injury frequently completely eliminates visible evidence of scar formation. However, efforts to define the cellular and structural mechanisms by which this phenomenon occurs have been limited in their success.
  
  
  OBJECTIVE
  We investigated wound healing after dermabrasive scar revision.
  
  
  METHODS
  The surgical scars of seven patients were abraded 6-8 weeks after injury. Comparative electron microscopic and immunohistochemical studies were performed on punch biopsy specimens taken before and after the dermabrasion. Ultrastructural changes in the basement membrane components and dermal structures were evaluated. Monoclonal antibody staining techniques were used to observe the presence, location, and temporal expression of tenascin, epiligrin, cadherins, and integrin subunits.
  
  
  RESULTS
  We observed: 1) an increase in collagen bundle density and size with a tendency toward unidirectional orientation of fibers parallel to the epidermal surface, 2) an upregulation of tenascin expression throughout the papillary dermis, and 3) expression of alpha-6/beta-4 integrin subunit on the keratinocytes throughout the stratum spinosum.
  
  
  CONCLUSIONS
  The mechanisms by which dermabrasive scar revision alters the events of primary cicatrix formation include modification of extracellular ligand expression, thereby influencing epithelial cell-cell interaction, and reorganization of connective tissue.
authors.affiliation: Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Harmon
authors.forename: B D
authors.initials: BD
authors.lastname: Zelickson
authors.forename: R K
authors.initials: RK
authors.lastname: Roenigk
authors.forename: E A
authors.initials: EA
authors.lastname: Wayner
authors.forename: B
authors.initials: B
authors.lastname: Hoffstrom
authors.forename: M R
authors.initials: MR
authors.lastname: Pittelkow
authors.forename: D G
authors.initials: DG
authors.lastname: Brodland
mesh_terms: D000954:Antigens, Surface / Q000032:analysis / Q000235:genetics; D001485:Basement Membrane / Q000378:metabolism / Q000648:ultrastructure; D015820:Cadherins / Q000032:analysis; D015815:Cell Adhesion Molecules / Q000032:analysis; D015816:Cell Adhesion Molecules, Neuronal / Q000032:analysis / Q000235:genetics; D002450:Cell Communication; D002921:Cicatrix / Q000378:metabolism / Q000473:pathology / Q000601:surgery*; D003094:Collagen / Q000648:ultrastructure; D003238:Connective Tissue / Q000378:metabolism / Q000648:ultrastructure; D003869:Dermabrasion; D004848:Epithelium / Q000378:metabolism / Q000648:ultrastructure; D000939:Epitopes / Q000032:analysis / Q000235:genetics; D016326:Extracellular Matrix Proteins / Q000032:analysis / Q000235:genetics; D015870:Gene Expression; D006801:Humans; D007150:Immunohistochemistry; D039161:Integrin alpha6beta4; D016023:Integrins / Q000032:analysis / Q000235:genetics; D015603:Keratinocytes / Q000378:metabolism; D008854:Microscopy, Electron; D009419:Nerve Tissue Proteins / Q000032:analysis / Q000235:genetics; D012867:Skin / Q000378:metabolism* / Q000648:ultrastructure*; D019063:Tenascin; D015854:Up-Regulation; D014945:Wound Healing; D000097794:Kalinin
chemical_list: D000954:Antigens, Surface; D015820:Cadherins; D015815:Cell Adhesion Molecules; D015816:Cell Adhesion Molecules, Neuronal; D003094:Collagen; D000939:Epitopes; D016326:Extracellular Matrix Proteins; D039161:Integrin alpha6beta4; D016023:Integrins; D009419:Nerve Tissue Proteins; D019063:Tenascin; D000097794:Kalinin