title: Hypertrophic versus non hypertrophic scars compared by immunohistochemistry and laser confocal microscopy: type I and III collagens.
abstract: Although dermal collagens appear increased in hypertrophic scars, this has not been tested in tissue samples using objective methods. We compared the expression of types I and III collagen in hypertrophic and non hypertrophic scars at 6-12 and 18-24 months after burn using a quantitative method. Among 17 patients with extensive burns, 3 patients had acute scars, 8 had hypertrophic or non hypertrophic scars at 6-12 months after burn and 6 had hypertrophic or non hypertrophic scars at 18-24 months after burn. After clinical assessment of scars using the Vancouver scale, immunohistochemistry for types I and III collagens was performed. Images were captured with a laser scanning confocal microscope and the relative amounts of types I and III collagens were determined in superficial and deep dermis. The effects of time and scar type were assessed using two-way analysis of variance (ANOVA) and Tukey's test. Collagen III scar/normal ratios were higher in hypertrophic scars at both time points (P = 0.05). There were no differences in collagen I scar/normal ratios. Large variation was observed in scars during the acute phase regarding the expression of collagens. Easily accessed by immunohistochemistry and confocal microscopy, type III collagen deposition may help in determining scar phenotype, differentiating hypertrophic and non hypertrophic scars.
authors.affiliation: Shriners Burns Hospital, Galveston, TX, USA.
authors.forename: Gisele V
authors.initials: GV
authors.lastname: Oliveira
authors.forename: Hal K
authors.initials: HK
authors.lastname: Hawkins
authors.forename: David
authors.initials: D
authors.lastname: Chinkes
authors.forename: Ann
authors.initials: A
authors.lastname: Burke
authors.forename: Andre Luiz Pasqua
authors.initials: AL
authors.lastname: Tavares
authors.forename: Marcia
authors.initials: M
authors.lastname: Ramos-e-Silva
authors.forename: Thomas B
authors.initials: TB
authors.lastname: Albrecht
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Kitten
authors.forename: David N
authors.initials: DN
authors.lastname: Herndon
mesh_terms: D000293:Adolescent; D002056:Burns / Q000150:complications / Q000378:metabolism / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000378:metabolism / Q000473:pathology*; D024042:Collagen Type I / Q000032:analysis*; D024061:Collagen Type III / Q000032:analysis*; D005500:Follow-Up Studies; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008297:Male; D018613:Microscopy, Confocal / Q000379:methods*; D012867:Skin / Q000293:injuries / Q000378:metabolism / Q000473:pathology; D015599:Trauma Severity Indices; D014945:Wound Healing / Q000502:physiology*
chemical_list: D024042:Collagen Type I; D024061:Collagen Type III