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Fu X, Taghizadeh A, Taghizadeh M, Li CJ, Lim NK, Lee J, Kim HS, Kim H. Targeting Nuclear Mechanics Mitigates the Fibroblast Invasiveness in Pathological Dermal Scars Induced by Matrix Stiffening. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2308253. [PMID: 38353381 PMCID: PMC11022731 DOI: 10.1002/advs.202308253] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/04/2024] [Indexed: 04/18/2024]
Abstract
Pathological dermal scars such as keloids present significant clinical challenges lacking effective treatment options. Given the distinctive feature of highly stiffened scar tissues, deciphering how matrix mechanics regulate pathological progression can inform new therapeutic strategies. Here, it is shown that pathological dermal scar keloid fibroblasts display unique metamorphoses to stiffened matrix. Compared to normal fibroblasts, keloid fibroblasts show high sensitivity to stiffness rather than biochemical stimulation, activating cytoskeletal-to-nuclear mechanosensing molecules. Notably, keloid fibroblasts on stiff matrices exhibit nuclear softening, concomitant with reduced lamin A/C expression, and disrupted anchoring of lamina-associated chromatin. This nuclear softening, combined with weak adhesion and high contractility, facilitates the invasive migration of keloid fibroblasts through confining matrices. Inhibiting lamin A/C-driven nuclear softening, via lamin A/C overexpression or actin disruption, mitigates such invasiveness of keloid fibroblasts. These findings highlight the significance of the nuclear mechanics of keloid fibroblasts in scar pathogenesis and propose lamin A/C as a potential therapeutic target for managing pathological scars.
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Affiliation(s)
- Xiangting Fu
- Institute of Tissue Regeneration Engineering (ITREN)Dankook UniversityCheonan31116Republic of Korea
- Department of Nanobiomedical Science and BK21 Global Research Center for Regeneration MedicineDankook UniversityCheonan31116Republic of Korea
| | - Ali Taghizadeh
- Institute of Tissue Regeneration Engineering (ITREN)Dankook UniversityCheonan31116Republic of Korea
- Department of Nanobiomedical Science and BK21 Global Research Center for Regeneration MedicineDankook UniversityCheonan31116Republic of Korea
| | - Mohsen Taghizadeh
- Institute of Tissue Regeneration Engineering (ITREN)Dankook UniversityCheonan31116Republic of Korea
- Department of Nanobiomedical Science and BK21 Global Research Center for Regeneration MedicineDankook UniversityCheonan31116Republic of Korea
| | - Cheng Ji Li
- Institute of Tissue Regeneration Engineering (ITREN)Dankook UniversityCheonan31116Republic of Korea
- Department of Nanobiomedical Science and BK21 Global Research Center for Regeneration MedicineDankook UniversityCheonan31116Republic of Korea
| | - Nam Kyu Lim
- Department of Plastic and Reconstructive SurgeryDankook University Hospital (DKUH)Cheonan31116Republic of Korea
- Dankook Physician Scientist Research CenterDankook University Hospital (DKUH)Cheonan31116Republic of Korea
| | - Jung‐Hwan Lee
- Institute of Tissue Regeneration Engineering (ITREN)Dankook UniversityCheonan31116Republic of Korea
- Department of Nanobiomedical Science and BK21 Global Research Center for Regeneration MedicineDankook UniversityCheonan31116Republic of Korea
- Department of Biomaterials Science, College of DentistryDankook UniversityCheonan31116Republic of Korea
- Cell & Matter InstituteDankook UniversityCheonan31116Republic of Korea
- Mechanobiology Dental Medicine Research CenterDankook UniversityCheonan31116Republic of Korea
| | - Hye Sung Kim
- Institute of Tissue Regeneration Engineering (ITREN)Dankook UniversityCheonan31116Republic of Korea
- Department of Nanobiomedical Science and BK21 Global Research Center for Regeneration MedicineDankook UniversityCheonan31116Republic of Korea
- Mechanobiology Dental Medicine Research CenterDankook UniversityCheonan31116Republic of Korea
| | - Hae‐Won Kim
- Institute of Tissue Regeneration Engineering (ITREN)Dankook UniversityCheonan31116Republic of Korea
- Department of Nanobiomedical Science and BK21 Global Research Center for Regeneration MedicineDankook UniversityCheonan31116Republic of Korea
- Department of Biomaterials Science, College of DentistryDankook UniversityCheonan31116Republic of Korea
- Cell & Matter InstituteDankook UniversityCheonan31116Republic of Korea
- Mechanobiology Dental Medicine Research CenterDankook UniversityCheonan31116Republic of Korea
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Isoldi FC, Garcia A, Vieites L, Ferreira LM. Keloids in male genitalia-Systematic review and illustrative case report. Wound Repair Regen 2024; 32:171-181. [PMID: 38351501 DOI: 10.1111/wrr.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Revised: 01/03/2024] [Accepted: 01/16/2024] [Indexed: 03/12/2024]
Abstract
Keloid is the maximum expression of pathological fibroproliferative skin wound healing, whose pathophysiology is not yet fully understood. Its occurrence in the perineum and genitalia is uncommon. A systematic review was carried out regarding the occurrence and treatment of keloids on the penis. An illustrative case was also reported. The review used the PRISMA checklist and was registered in PROSPERO. The entire literature period up to April 2023 was searched in the EMBASE/Elsevier, Cochrane, Scopus, Medline, BVS, SciELO, and Lilacs databases. The inclusion criteria embraced primary studies, clinical trials, prospective or retrospective cohorts, case series, case-control studies and case reports. Three hundred and sixty-one studies were found and 12 of them were included, consisting of 9 case reports and 3 case series. The most common triggering factor for keloid formation was circumcision, in 11 of the cases, of which more than half occurred in prepubescent children. Several therapies, associated or isolated, were used to treat the cases. Only one of the reported patients had scar recurrence after surgical treatment. Studies with better scientific evidence are needed to understand the involvement of keloids in male genitalia. However, keloid formation in this topography is rare, making it difficult to carry out more elaborate studies.
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Affiliation(s)
- Felipe Contoli Isoldi
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
| | - Ariane Garcia
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
| | - Luiza Vieites
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
| | - Lydia Masako Ferreira
- Postgraduate Program in Translational Surgery at Universidade Federal de São Paulo - Escola Paulista de Medicina (Unifesp/EPM), São Paulo, Brazil
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Multimodal Management of Facial Keloid with Tissue Expansion, Excision, and Injection of 5-FU and Triamcinolone. Plast Reconstr Surg Glob Open 2023; 11:e4796. [PMID: 36776588 PMCID: PMC9911190 DOI: 10.1097/gox.0000000000004796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 12/05/2022] [Indexed: 02/04/2023]
Abstract
Keloids are benign, fibroproliferative dermal growths that occur in response to injury of the skin. These hypertrophic scars can cause pain and discomfort and have been associated with negative effects on social well-being, prompting physicians to seek effective treatment modalities with minimal risk of recurrence. Although surgical excision of the keloid initially removes the scar tissue, surgery alone triggers a fibroproliferative response similar to the initial insult, resulting in a high recurrence rate. Thus, a multimodal approach may be most appropriate when surgery is indicated to limit recurrence. We present the successful treatment of recalcitrant keloid formation of the face that was treated with tissue expansion, excision, and intralesional triamcinolone and 5-flurouracil injections.
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Zhuang BY, Hu FC, You Y, Zhang L. Observation of the clinical efficacy of isotope phosphorus-32 dressing combined with diprospan and mucopolysaccharide polysulphate cream in the treatment of keloids. J Cosmet Dermatol 2022; 21:7140-7146. [PMID: 36169608 DOI: 10.1111/jocd.15418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 08/22/2022] [Accepted: 09/26/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The present study aims to investigate the effectiveness, recurrence, and adverse reaction rates of isotope phosphorus-32 dressings combined with diprospan and mucopolysaccharide polysulphate cream in the treatment of keloids. METHODS A total of 80 patients with keloids admitted to the Dermatology Clinic of the Fourth Affiliated Hospital of Harbin Medical University between June 2019 and June 2021 were included in the present study and randomly divided into three groups: Control Group 1 (n = 27), Control Group 2 (n = 25), and the treatment group (n = 28). Patients in Control Group 1 were treated with diprospan combined with mucopolysaccharide polysulphate cream, patients in Control Group 2 were treated with an isotopic phosphorus-32 dressing combined with mucopolysaccharide polysulphate cream, and patients in the treatment group were treated with an isotopic phosphorus-32 dressing combined with diprospan and mucopolysaccharide polysulphate cream. The effectiveness, recurrence, and adverse reaction rates were observed in all three groups. RESULTS The treatment group had the most significant decrease in the itching scores. The respective effectiveness, recurrence, and adverse reaction rates were 81.4%, 43.6%, and 74.1% in Control Group 1; 56%, 38.7%, and 64% in Control Group 2; and 96.7%, 11.2%, and 41% in the treatment group. The differences were statistically significant (p < 0.05). CONCLUSION An isotope phosphorus-32 dressing combined with diprospan and mucopolysaccharide polysulphate cream keloid treatment delivers a fast onset, good effectiveness, and low recurrence and adverse effect rates.
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Affiliation(s)
- Bin-Yu Zhuang
- Department of Dermatology, The Fourth Affiliated Hospital of Harbin Medical University, Haerbin, China
| | - Fang-Chi Hu
- Department of Orthopeadic Surgery, Harbin First Hospital, Haerbin, China
| | - Yan You
- Department of Dermatology, The Fourth Affiliated Hospital of Harbin Medical University, Haerbin, China
| | - Liang Zhang
- Department of Dermatology, The Fourth Affiliated Hospital of Harbin Medical University, Haerbin, China
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Kim M, Mirsky N, Spielman A, Mathew P, Yechieli R, Tang JC, Thaller SR. Evaluating Symptomatic and Psychosocial Well-being After Keloid Treatment With SCAR-Q. Aesthet Surg J 2022; 42:NP416-NP422. [PMID: 35224618 DOI: 10.1093/asj/sjac043] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Many patients with keloids experience symptoms, such as pain and pruritus, and may present with significant psychosocial burdens. However, no single therapeutic regimen has been firmly established for treatment of keloids. OBJECTIVES The aim of this study was to assess patients' perspectives on their keloids after treatment by comparing preoperative and postoperative surveys. METHODS All patients seen at the keloid clinic, both preoperatively and postoperatively, were contacted by telephone call. Information about demographics, keloid characteristics, and levels of pain and pruritus were recorded. Participants also completed all 3 parts (appearance, symptoms, and psychosocial impact) of the SCAR-Q, a validated patient-reported outcome measure questionnaire. Statistical analysis was performed with SPSS version 23 (IBM Corp., Armonk, NY). RESULTS Of the 60 patients who participated in the study, 35 preoperative and 34 postoperative surveys were completed. Patients experienced significant reductions in mean [standard deviation] pain levels (from 5.6 [4.0] to 0.1 [0.4], P < 0.001) and pruritus (from 6.5 [3.0] to 0.8 [1.5], P < 0.001) postintervention. Significant improvements in all 3 parts of the SCAR-Q were noted. Appearance improved from 26.5 [22.3] to 73.4 [23.0] (P < 0.001); symptoms from 44.0 [15.7] to 81.4 [16.7] (P < 0.001); and psychosocial impact from 27.7 [30.7] to 82.6 [26.3] (P < 0.001). CONCLUSIONS Patients with keloids experience significant improvement in their symptomatic and psychosocial burden after treatment. Although management modalities are not well established, it is essential that plastic surgeons do not overlook the therapeutic benefits for their patients' well-being.
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Affiliation(s)
- Minji Kim
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nicholas Mirsky
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Amanda Spielman
- University of Miami Miller School of Medicine, Miami, FL, USA
| | - Prakash Mathew
- Division of Plastic Surgery, University of Pennsylvania, Pennsylvania, PA, USA
| | - Raphael Yechieli
- Department of Radiation Oncology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jennifer C Tang
- Dr Philip Frost Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Seth R Thaller
- Division of Plastic, Aesthetic, and Reconstructive Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
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Pires JA, Bragato EF, Momolli M, Guerra MB, Neves LM, de Oliveira Bruscagnin MA, Ratto Tempestini Horliana AC, Porta Santos Fernandes K, Kalil Bussadori S, Agnelli Mesquita Ferrari R. Effect of the combination of photobiomodulation therapy and the intralesional administration of corticoid in the preoperative and postoperative periods of keloid surgery: A randomized, controlled, double-blind trial protocol study. PLoS One 2022; 17:e0263453. [PMID: 35167583 PMCID: PMC8846523 DOI: 10.1371/journal.pone.0263453] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 01/20/2022] [Indexed: 11/18/2022] Open
Abstract
Keloid scars are characterized by the excessive proliferation of fibroblasts and an imbalance between the production and degradation of collagen, leading to its buildup in the dermis. There is no “gold standard” treatment for this condition, and the recurrence is frequent after surgical procedures removal. In vitro studies have demonstrated that photobiomodulation (PBM) using the blue wavelength reduces the proliferation speed and the number of fibroblasts as well as the expression of TGF-β. There are no protocols studied and established for the treatment of keloids with blue LED. Therefore, the purpose of this study is to determine the effects of the combination of PBM with blue light and the intralesional administration of the corticoid triamcinolone hexacetonide on the quality of the remaining scar by Vancouver Scar Scale in the postoperative period of keloid surgery. A randomized, controlled, double-blind, clinical trial will be conducted involving two groups: 1) Sham (n = 29): intralesional administration of corticoid (IAC) and sham PBM in the preoperative and postoperative periods of keloid removal surgery; and 2) active PBM combined with IAC (n = 29) in the preoperative and postoperative periods of keloid removal surgery. Transcutaneous PBM will be performed on the keloid region in the preoperative period and on the remaining scar in the postoperative period using blue LED (470 nm, 400 mW, 4J per point on 10 linear points). The patients will answer two questionnaires: one for the assessment of quality of life (Qualifibro-UNIFESP) and one for the assessment of satisfaction with the scar (PSAQ). The team of five plastic surgeons will answer the Vancouver Scar Scale (VSS). All questionnaires will be administered one, three, six, and twelve months postoperatively. The keloids will be molded in silicone prior to the onset of treatment and prior to excision to assess pre-treatment and post-treatment size. The same will be performed for the remaining scar at one, three, six, and twelve months postoperatively. The removed keloid will be submitted to histopathological analysis for the determination of the quantity of fibroblasts, the organization and distribution of collagen (picrosirius staining), and the genic expression of TGF-β (qPCR). All data will be submitted to statistical analysis.
Trial registration: This study is registered in ClinicalTrials.gov (ID: NCT04824612).
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Affiliation(s)
- Jefferson André Pires
- Department of Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
- Department of Plastic Surgery, Mandaqui Hospital Complex, São Paulo, São Paulo, Brazil
| | - Erick Frank Bragato
- Department of Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
| | - Marcos Momolli
- Department of Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
| | - Marina Bertoni Guerra
- Department of Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
| | - Leonel Manea Neves
- Department of Plastic Surgery, Mandaqui Hospital Complex, São Paulo, São Paulo, Brazil
| | | | | | | | - Sandra Kalil Bussadori
- Department of Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
| | - Raquel Agnelli Mesquita Ferrari
- Department of Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
- Department of Rehabilitation Science Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, São Paulo, Brazil
- * E-mail:
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Abstract
Introduction: As the size and influence of online dermatologic communities have developed significantly in recent years, literature concerning the relationship between social media and dermatology grows more important. One community of interest is r/SkincareAddiction, a forum of over 1.2 million members on Reddit that serves as both a support group and discussion aggregator sourcing information from multiple social media platforms. Methods: This study reports on the qualitative analysis of 300 highly engaged posts to identify prominent themes in online dermatologic discussions and determine the extent of multiplatform interaction between Reddit and other dermatology-relevant social networks. Results: Results of an inductive analysis indicate discussions place an emphasis on communicating advice and improving general wellbeing, comprising 71% of measured posts. However, a large portion of this counsel lacks evidence and pseudoscientific recommendations are often accepted as factual. Additionally, 31% of entries were drawn from alternative social media sites. Conclusion: Assessing the prevalent points of discussion in dermatology-relevant communities can inform clinical practice and reveal alternative methods to advance the delivery of care. As patients increasingly seek health advice and support online, developing digital literacy in common dermatologic trends offers a unique opportunity to improve communication, disseminate evidence-based counsel, and combat misinformation in both clinical and online settings.
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Affiliation(s)
- Aakash Reddy
- College of Natural Sciences, University of Texas at Austin, Austin, USA
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