The formation of keloids may be due to a genetically based switch normalization failure in the remodeling stage of wound healing, says Greg Goodman, M.D., associate professor of dermatology, Monash University, Clayton, Victoria, Australia, who recently spoke on the topic at the World Congress of Dermatology in Milan.
According to Dr. Goodman, the wound healing process is a continuum that progresses from scarless fetal wound healing to adult wound healing to keloidal wound healing. Adult wound healing is scarred but still considered normal, whereas keloidal wound healing is characterized as uncontrolled persisting proliferation of scar tissue.
The three overlapping phases of wound healing are an inflammatory phase, a proliferative phase, and a remodeling phase; and it is the abnormal perpetuation of the proliferative phase due to the switch normalization failure into the remodeling phase that results in keloid formation in predisposed individuals.
“Why this physiologic turn-off switch does not occur in the keloid patient population remains an unknown,” he notes. “However, there is some evidence that the formation of keloids is genetically based, which could be the focus and direction for potential future therapeutic interventions that could help prevent keloid formation.”
Keloids are benign growths of dense fibrous tissue that develop from an abnormal response to a cutaneous injury. Keloids are a challenge to treat and manage because they’re often symptomatic and can have a significant psychosocial impact in affected patients.
Dr. Goodman reports no relevant disclosures.