[Examining the pathogenesis and therapeutic strategy of keloids from the perspective of systemic inflammation]

Zhonghua Shao Shang Za Zhi. 2020 May 20;36(5):334-338. doi: 10.3760/cma.j.cn501120-20200401-00205.
[Article in Chinese]

Abstract

Keloid is a disease that is difficult to cure and has a high recurrence rate. In the past, research on keloid focused on keloid cells themselves and the therapeutic strategy limited to local treatment, whereas the role of systemic factors in the process of occurrence and development of disease was usually neglected. Based on the literature reports and clinical evidence, we propose that the pro-inflammatory constitution of keloid patients can serve as a systemic factor to interact with local factors such as skin lesion, and thus leads to the initiation and development of keloid. The classical theory about close relationship between visceral malfunctions and skin diseases described in traditional Chinese medicine has provided supporting evidence. Therefore, we suggest that systemic anti-inflammatory therapy should be included in the design of future keloid therapeutic strategies and be verified by the clinical trials. Additionally, the therapeutic strategies of traditional Chinese medicine including anti-dampness, detoxing and heating removing can also be employed as a part of systemic treatment of keloids.

瘢痕疙瘩是一种高复发和难愈性疾病。既往对该疾病的机制研究和治疗策略聚焦在细胞本身和局部治疗,忽略了患者全身性因素对疾病发生发展所起的作用。基于现有的文献报道和临床证据,笔者提出瘢痕疙瘩患者的炎症体质可作为全身性因素与皮损等局部因素形成相互作用,引发瘢痕疙瘩的形成和持续发展,祖国医学脏腑功能与皮肤疾病关联性的经典理论为此提供了重要的佐证。故此,笔者进一步提出需要将全身性抗炎治疗纳入未来瘢痕疙瘩治疗策略设计中,并进行临床验证。中医的祛湿与清热解毒策略则可作为瘢痕疙瘩全身治疗的组成部分。.

Keywords: Keloid; Local and systemic interaction; Pro-inflammatory constitution; Systemic therapy; Traditional Chinese medicine.

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use*
  • Humans
  • Inflammation
  • Keloid / immunology
  • Keloid / pathology*
  • Keloid / therapy*
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents