Morphogenetic and pathogenetic features of hypertrophic and keloid scars of the head and neck

Kogan E.A.; Andreeva V.V.; Reshetov I.V.; Demura T.A.; Zharkov N.V.

doi:https://doi.org/10.17116/patol20228406123

Kogan E.A.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-1775-3060

Andreeva V.V.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

Reshetov I.V.

I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of Russia

ORCID: 0000-0002-3888-8004

Demura T.A.

Sechenov First Moscow State Medical University

SPIN RSCI: 2198-5765
Scopus AuthorID: 25936132400
ORCID: 0000-0002-6946-6146

Zharkov N.V.

Sechenov First Moscow State Medical University

Morphogenetic and pathogenetic features of hypertrophic and keloid scars of the head and neck

Authors:

Kogan E.A., Andreeva V.V., Reshetov I.V., Demura T.A., Zharkov N.V.

More about the authors

Journal: Russian Journal of Archive of Pathology. 2022;84(6): 23‑31

DOI: 10.17116/patol20228406123

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To cite this article:

Kogan EA, Andreeva VV, Reshetov IV, Demura TA, Zharkov NV. Morphogenetic and pathogenetic features of hypertrophic and keloid scars of the head and neck. Russian Journal of Archive of Pathology. 2022;84(6):23‑31. (In Russ.)
https://doi.org/10.17116/patol20228406123

Подписка 2026 Архив патологии (Russian Journal of Archive of Pathology)

Использование инфографики авторами научных работ

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OBJECTIVE

Evaluate the morphogenetic and pathogenetic features of hypertrophic and keloid scars of the head and neck.

MATERIAL AND METHODS

The study included 286 patients, among them 176 (61.5%) patients with hypertrophic and 110 (38.5%) with keloid scars aged 18 to 65 years with a disease duration from 1 month to 2 years. Material for histological and immunohistochemical (IHC) studies of scar tissue was fixed in 10% buffered formalin. Serial paraffin sections were stained with H&E, according to Van Gieson and Weigert. IHC was performed using monoclonal mouse antibodies to collagen type I (clone 3G3, Santa Cruz, dilution 1:100), collagen type III (clone B-4, Santa Cruz, dilution 1:50), collagen type IV (clone COL-94, Santa Cruz, dilution 1:50), MMP-1 (clone 3B6, Santa Cruz, dilution 1:100), α-SMA1 (clone 1A4, Dako Agilent, dilution 1:100) and rabbit polyclonal anti-TGFβ antibodies (clone 3C11, Santa Cruz, 1:100 dilution).

RESULTS

Pathogenetic, morphological and immunohistochemical differences in hypertrophic and keloid scars were established depending on their degree of maturity. In the formation of hypertrophic scars, the key factor in sclerotic processes is TGF-b on the background of low MMP1 activity. Keloid scars were distinguished not only by the accumulation of hard-to-degrade collagens, but also by the development of an osteoclast-like reaction with a high content of MMP1. Immature scar tissue was characterized by the presence of myofibroblastic α-SMA1 positive focus and center of inflammatory changes.

CONCLUSIONS

The data obtained allow substantiating new approaches to the treatment of patients with hypertrophic and keloid scars.

Keywords:

keloid

hypertrophic scar

immunohistochemistry

collagens

angiogenesis

osteoclasts

TGF

MMP1

α-SMA

myofibroblasts

Authors:

Kogan E.A.

Sechenov First Moscow State Medical University

ORCID: 0000-0003-1775-3060

Andreeva V.V.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

Reshetov I.V.

I.M. Sechenov First Moscow State Medical University (Sechenov University) of the Ministry of Health of Russia

ORCID: 0000-0002-3888-8004

Demura T.A.

Sechenov First Moscow State Medical University

SPIN RSCI: 2198-5765
Scopus AuthorID: 25936132400
ORCID: 0000-0002-6946-6146

Zharkov N.V.

Sechenov First Moscow State Medical University

Received:

08.09.2022

Accepted:

22.09.2022

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References:

Ozerskaya OS. Skin scars and their dermatocosmetological correction. SPb.: OAO «Art of Russia»; 2007. (In Russ.).
Dorfmüller M. Psychological management and after-care of severely burned patients. Unfallchirurg. 1995;98(4):213-217. (In German).
Filippova OV, Afonichev KA, Krasnogorskii IN, Vashetko RV. Clinical and morphological features of the vascular bed of hypertrophic scar tissue at different times of its formation. Orthopedics, traumatology and reconstructive surgery of childhood. 2017;5(3)25-35. (In Russ.). https://doi.org/10.17816/PTORS5325-36
Kovalyeva LN. Clinical and morphological parallels in patients with cicatricial skin pathology. Dermatovenereology. Cosmetology. Sexual Pathology. 2016;(1-4):108-117. (In Russ.).
Mishina ES, Zatolokina MA, Sergeeva SYu. Study of factors of dynamic structuring of collagen fibers in the experiment. Morphology. 2019;155(2):199. (In Russ.).
Omel’yanenko NP, Slutskii LI. Connective tissue (histophysiology and biochemistry). M.: Izvestiya; 2009. (in Russ.).
Fetisov SO, Alekseeva NT, Nikityuk DB, Serezhenko NP, Atyakshin DA. Modeling as a method of assessing specific morphofunctional patterns in regeneration. Journal of Anatomy and Histopathology. 2015;4(4):49-55. (In Russ.).
Rünger TM, Quintanilla-Dieck MJ, Bhawan J. Role of cathepsin K in the turnover of the dermal extracellular matrix during scar formation. J Invest Dermatol. 2007;127(2):293-297. https://doi.org/10.1038/sj.jid.5700535
Fourman MS, McKenna P, Phillips BT, Crawford L, Romanelli F, Lin F, McClain SA, Khan SU, Dagum AB, Singer AJ, et al. ICG angiography predicts burn scarring within 48 h of injury in a porcine vertical progression burn model. Burns. 2015;41(5):1043-1048. https://doi.org/10.1016/j.burns.2014.11.001
Liu W, Wang DR, Cao YL. TGF-beta: a fibrotic factor in wound scarring and a potential target for anti-scarring gene therapy. Curr Gene Ther. 2004;4(1):123-136. https://doi.org/10.2174/1566523044578004
Mavlikeev MO, Arkhipova SS, Chernova ON, Titova AA, Pevnev GO, Shafigullina AK, Kiyasov AP. Short course of histological technique. Kazan’: Kazanskii federal’nyi universitet; 2020. (In Russ.).
Shishkina VV, Atyakshin DA. Mast cells and fibrillogenesis of collagen in conditions of weightlessness. Journal of Anatomy and Histopathology. 2019;8(3):79-88. (In Russ.). https://doi.org/10.18499/2225-7357-2019-8-3-79-88
Kumar V, Abbas AK, Aster J, eds. Robbins and Cotran pathologic basis of disease. 10th ed. Elsevier; 2020.
Kumar GL, Rudbeck L, eds. Pathology. Education guide. Immunohistochemical staining methods. 5th ed. Dako North America; 2009.
Hinz B. Myofibroblasts. Exp Eye Res. 2016;142:56-70. https://doi.org/10.1016/j.exer.2015.07.009
Limandjaja GC, Belien JM, Scheper RJ, Niessen FB, Gibbs S. Hypertrophic and keloid scars fail to progress from the CD34−/α-smooth muscle actin (α-SMA)+ immature scar phenotype and show gradient differences in α-SMA and p16 expression. Br J Dermatol. 2020;182(4):974-986. https://doi.org/10.1111/bjd.18219
Hu HH, Chen DQ, Wang YN, Feng YL, Cao G, Vaziri ND, Zhao YY. New insights into TGF-β/Smad signaling in tissue fibrosis. Chem Biol Interact. 2018;292:76-83. https://doi.org/10.1016/j.cbi.2018.07.008
Sheridan RL. Burn care: results of technical and organizational progress. JAMA. 2003;290(6):719-722. https://doi.org/10.1001/jama.290.6.719
Taal L, Faber AW. Posttraumatic stress and maladjustment among adult burn survivors 1 to 2 years post burn. Part II: the interview data. Burns. 1998;24(5):399-405. https://doi.org/10.1016/s0305-4179(98)00053-9