title: Keloids and Hypertrophic Scars: A Spectrum of Clinical Challenges.
abstract: Since their earliest description, keloids and hypertrophic scars have beleaguered patients and clinicians alike. These scars can be aesthetically disfiguring, functionally debilitating, emotionally distressing, and psychologically damaging, culminating in a significant burden for patients. Our current understanding of keloid pathophysiology has grown and continues to advance while molecular biology, genetics, and technology provide ever-deepening insight into the nature of wound healing and the pathologic perturbations thereof. Greater understanding will lead to the development and application of refined therapeutic modalities. This article provides an overview of our current understanding of keloids, highlighting clinical characteristics and diagnostic criteria while providing a comprehensive summary of the many therapeutic modalities available. The proposed mechanism, application, adverse events, and reported efficacy of each modality is evaluated, and current recommendations are summarized.
authors.affiliation: Department of Radiology, Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Anthony P
authors.initials: AP
authors.lastname: Trace
authors.affiliation: The School of Medicine, Eastern Virginia Medical School, Norfolk, VA, USA.
authors.forename: Clinton W
authors.initials: CW
authors.lastname: Enos
authors.affiliation: Hampton University Skin of Color Research Institute, Hampton University, Hampton, VA, USA.
authors.forename: Alon
authors.initials: A
authors.lastname: Mantel
authors.affiliation: Hampton University Skin of Color Research Institute, Hampton University, Hampton, VA, USA. harveyvm@evms.edu.|Department of Dermatology, Eastern Virginia Medical School, 721 Fairfax Ave., Norfolk, VA, 23507, USA. harveyvm@evms.edu.
authors.forename: Valerie M
authors.identifier: http://orcid.org/0000-0002-9623-4009
authors.initials: VM
authors.lastname: Harvey
mesh_terms: D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000634:Aminoquinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000963:Antimetabolites / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D049109:Cell Proliferation; D017439:Cicatrix, Hypertrophic / Q000209:etiology / Q000473:pathology / Q000628:therapy; D002986:Clinical Trials as Topic; D003094:Collagen / Q000378:metabolism; D003131:Combined Modality Therapy / Q000379:methods; D017679:Cryotherapy / Q000379:methods; D005109:Extracellular Matrix / Q000502:physiology; D005347:Fibroblasts / Q000502:physiology*; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D000077271:Imiquimod; D007249:Inflammation / Q000378:metabolism; D007627:Keloid / Q000209:etiology / Q000473:pathology / Q000628:therapy; D053685:Laser Therapy / Q000379:methods; D014945:Wound Healing / Q000502:physiology*
chemical_list: D000276:Adjuvants, Immunologic; D000634:Aminoquinolines; D000893:Anti-Inflammatory Agents; D000903:Antibiotics, Antineoplastic; D000963:Antimetabolites; D005938:Glucocorticoids; D001761:Bleomycin; D003094:Collagen; D000077271:Imiquimod; D005472:Fluorouracil