PURPOSE: Excessive scarring in the forms of keloid and hypertrophic scar could be a consequence of the accumulation of granulation tissue cells due to aberrant control of apoptosis. Verapamil retard extracelluar matrix production and inhibits VEGF production in primary cultured keloid fibroblast. The object of this study is to identify the effects of verapamil on VEGF expression and apoptosis in early wound scarring of the rabbit ear. METHODS: Full thickness wounds were created on the ventral side of 6 New Zealand rabbits's ear. 16 days after initial wounding verapamil and saline were injected on each scars, and the scars were harvested for 1 week, 2 weeks, and 4 weeks. The wounds were stained with hematoxylin and eosin, TUNEL stain, immunohistochemical stain for VEGF and calculated scar elevation index. RESULTS: Histologic analysis demonstrated significant reduction in inflammation, vascularity and improvement in dermal collagen organization in experimental group. In TUNEL staining apoptosis positive cells were increased and immunohistochemial staining of VEGF demonstrated significant reduction of VEGF expression in experimental group. No significant difference was noted in scar elevation index between two groups. CONCLUSION: This study suggest that intralesional injection of verapamil on early wound scarring of the rabbit ear decreased VEGF production and increased apoptosis and have a benefit on the pathophysiology of scar formation.
Apoptosis ; Cicatrix ; Cicatrix, Hypertrophic ; Collagen ; Ear ; Eosine Yellowish-(YS) ; Fibroblasts ; Granulation Tissue ; Hematoxylin ; In Situ Nick-End Labeling ; Inflammation ; Injections, Intralesional ; Keloid ; New Zealand ; Vascular Endothelial Growth Factor A ; Verapamil

Hypertrophic scars with proliferation of fibroblasts are noted in urethral stricture. Internal urethrotomy followed by intralesional injection of triamcinolone have been taken frequently to prevent recurrence of urethral stricture. To evaluate the effect of triamcinolone against stricture formation. we made iatrogenic urethral injury on two male dogs with one receiving simultaneous intralesional injection of triamcinolone and the other without injection. There were less inflammation. fewer granulation tissue formation (fewer fibroblast less capillary, less mucopolysaccharide deposit, less collagen) in early phase of wound healing and thinner fibrous scar tissue formation in later phase on the dog treated with triamcinolone injection than the doe without it. So. the effect of triamcinolone injection was thought to shorten the inflammatory response which resulted in small amount of granulation tissue with subsequently less degree of fibrous scar formation.
Animals ; Capillaries ; Cicatrix ; Cicatrix, Hypertrophic ; Constriction, Pathologic ; Dogs ; Fibroblasts ; Granulation Tissue ; Humans ; Inflammation ; Injections, Intralesional* ; Male ; Recurrence ; Triamcinolone* ; Urethral Stricture* ; Wound Healing

BACKGROUND: In the extremities of premature infants, the skin and subcutaneous tissue are very pliable due to immaturity and have a greater degree of skin laxity and mobility. Thus, we can expect wounds to heal rapidly by wound contraction. This study investigates wound healing of full-thickness defects in premature infant extremities. METHODS: The study consisted of 13 premature infants who had a total of 14 cases of full-thickness skin defects of the extremities due to extravasation after total parenteral nutrition. The wound was managed with intensive moist dressings with antibiotic and anti-inflammatory agents. After wound closure, moisturization and mild compression were performed. RESULTS: Most of the full-thickness defects in the premature infants were closed by wound contraction without granulation tissue formation on the wound bed. The defects resulted in 3 pinpoint scars, 9 linear scars, and 2 round hypertrophic scars. The wounds with less granulation tissue were healed by contraction and resulted in linear scars parallel to the relaxed skin tension line. The wounds with more granulation tissue resulted in round scars. There was mild contracture without functional abnormality in 3 cases with a defect over two thirds of the longitudinal length of the dorsum of the hand or foot. The patients' parents were satisfied with the outcomes in 12 of 14 cases. CONCLUSIONS: Full-thickness skin defects in premature infants typically heal by wound contraction with minimal granulation tissue and scar formation probably due to excellent skin mobility.
Anti-Inflammatory Agents ; Bandages ; Cicatrix ; Cicatrix, Hypertrophic ; Contracts ; Contracture ; Extremities ; Foot ; Granulation Tissue ; Hand ; Humans ; Infant, Newborn ; Infant, Premature ; Parenteral Nutrition, Total ; Parents ; Prognosis ; Skin ; Subcutaneous Tissue ; Wound Healing

Anterior glottic web is an abnormal scar tissue formation between the vocal folds, involving anterior commissure. Scarring procedure caused by damage to mucosal membranes of the vocal folds eventually can lead to glottic web formation, especially after laryngeal surgery involving both vocal folds. The conventional treatments of anterior glottic web have included keel, silicon or tube insertion. However, this presents risks of airway compromise and granulation tissue formation. CO2 laser web lysis has been widely used over the past decades. We introduced a novel, laser mucosal inversion technique for treating anterior glottic web and presented the case with a review of the related literatures.
Cicatrix ; Granulation Tissue ; Lasers, Gas ; Membranes ; Silicones ; Vocal Cords

No abstract available.
Burns* ; Granulation Tissue*

No abstract available.
Granulation Tissue ; Nails ; Poroma

Retroncyhia shows ingrowth of the nail toward the proximal nail folds. Initial events start from minor trauma of the digital pulp that disturbs longitudinal nail growth. This disturbed growth of the nail changes the growth direction to the proximal nail folds, leading to persistent paronychia, formation of granulation tissue, and other nail changes. Simple avulsion is curative and can improve most symptoms. There are few reports about retronychia in the English literature, and we report 3 cases of retronychia here.
Granulation Tissue ; Nails ; Paronychia

A 43-year-old man presented with well-defined purple to skin-colored 2X1cm sized plague and various sized papules on the posterior neck. Histopathological findings were follicular and perifollicular inflammation with plasma cells, lymphocytes and neutrophils and dermal fibrosis shown as hypertrophic scar tissue. The patient was diagnosed as acne keloidalis nuchae and treated by surgical excision. We report a case of acne keloidalis nuchae showing typical clinical and histopathological findings.
Acne Keloid* ; Acne Vulgaris* ; Adult ; Cicatrix, Hypertrophic ; Fibrosis ; Humans ; Inflammation ; Lymphocytes ; Neck ; Neutrophils ; Plague ; Plasma Cells

BACKGOUND: Pulsed dye laser (PDL) is recommended as a good treatment for scars and keloids. However, there has been no absolute indications and standard laser parameters. Some proposed that only hypertrophic and atrophic/flat scars were effectively treated, but others reported that all scars and even keloids responded well to PDL treatment. OBJECTIVE: To determine whether 595nm PDL treatment is effective for scars and keloids, and if so, which group responds better to treatment between the atrophic/flat scars group and hypertropic scars/keloids group. METHOD: Twenty-two patients (skin types III-V) with scars and keloids were treated with 595nm PDL (0.45 or 1.5 msec, 4-8J/cm(2), 7mm spot size). Eleven patients had hypertrophic scars/keloids (6 had hypertropic scars, 5 had keloids), and eleven patients had atrophic/flat scars. After several treatments of each lesion, the results were evaluated by extent of the patient's satisfaction and comparision of pre-and post-laser photography and divided into the four categories: excellent, good, fair and poor. RESULTS: The clinical improvement and patient's satisfaction were better in the atrophic/flat scars group than the hypertrophic scars/keloid group. With keloid potients, the result of treatment were found to be particularly poor. CONCLUSION: From our results, only atrophic/flat scars respond well to 595nm PDL treatment, and hypertrophic scars and keloids should be excluded from this treatments method.
Cicatrix* ; Cicatrix, Hypertrophic ; Humans ; Keloid* ; Lasers, Dye* ; Photography

BACKGROUND: Keloids and hypertrophic scars represent excessive scarring. They require different therapeutic approaches, which can be hampered because of an apparent lack of morphologic difference between the two diseases. OBJECTIVE: This study investigated the clinical and dermoscopic features of keloids and hypertrophic scars in order to help dermatologists distinguish these lesions better. METHODS: A total of 41 keloids and hypertrophic scars in 41 patients were examined clinically and by performing dermoscopy with a digital imaging system. Lesions were evaluated for vascular structures. RESULTS: Dermoscopy revealed vascular structures in most keloid lesions (90%) but in only 27% of hypertrophic scar lesions. The most common dermoscopic vascular structures in keloids were arborizing (52%), followed by linear irregular (33%) and commashaped (15%); these features were present but less evident in hypertrophic scars (9% for all types). The distribution frequency of the vascular structures differed significantly between diseases (p<0.001). CONCLUSION: A strong association of vascular structures with keloids was observed on dermoscopic examination. The results suggest dermoscopic examination of vascular structures is a clinically useful diagnostic tool for differentiating between keloids and hypertrophic scars.
Blood Vessels ; Cicatrix ; Cicatrix, Hypertrophic* ; Dermoscopy* ; Humans ; Keloid*