title: Clinical and histological correlation in post-burn hypertrophic scar for pain and itching sensation.
abstract: BACKGROUND
  Hypertrophic scar following a burn is caused by the excessive deposit of collagen resulting in an exaggerated wound healing response. The burn patient complains of pain and itching over the scar, which can give rise to cosmetic and functional problems.
  
  
  OBJECTIVE
  The aim of this study was to investigate the clinical and histological correlation of a hypertrophic burn scar for itching and pain sensations.
  
  
  METHODS
  Thirty-eight patients underwent a scar release and skin graft. the modified Vancouver scar scale and the verbal numerical rating scale were recorded. All biopsies were taken from scar tissue (scar) and normal tissue (normal). Histologically, tissues were observed in the epidermis, the monocytes around the vessels, the collagen fiber, elastic fiber, and the mast cells.
  
  
  RESULTS
  The mean total score of MVSS was 8.4±2.7 (pliability 2.0±0.9; thickness 1.8±0.9; vascularity 2.0± 0.9; and pigmentation 2.1±0.9). Pain and itching were 2.4±2.0 and 2.9±3.0. Epidermis were 7.9±2.8 layers (scar) and 4.0±0.8 layers (normal). The collagen fibers were thin and dense (scar) and thicker and loose (normal). The elastic fibers were thin and nonexistent (scar) and thin and loose (normal). Mast cells were 11.2±5.8/high power field (scar) and 7.4±4.1 (normal).
  
  
  CONCLUSIONS
  As the scar tissue thickens, the itching becomes more severe. The stiffness of the scar with the pain appeared to be associated with the condition of the tissue. The correlation between clinical and histological post-burn hypertrophic scars will help further studies on the scar. This helped with the development of the base material for therapeutic strategies.
authors.affiliation: Department of Pathology, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Young-Hee
authors.initials: YH
authors.lastname: Choi
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Kwang-Min
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Department of Dermatology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Hye-One
authors.initials: HO
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: Young-Chul
authors.initials: YC
authors.lastname: Jang
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
authors.forename: In-Suk
authors.initials: IS
authors.lastname: Kwak
keywords: Hypertrophic scar; Itching; Pain