scarring
Introduction
Introduction Scar hyperplasia, also known as keloid, is caused by excessive proliferation of fibrous connective tissue. The keloid ridge has a tumor-like hyperplasia, a smooth surface, a rosy and shiny color, and often found dilated capillaries. Skin damage extends outward from the edges and the crab feet deform. Skin lesions vary in size, shape difference, and hard, such as cartilage, and the symptoms are more itchy or painful or burning.
Cause
Cause
Wound: In the process of wound healing, the inflammatory reaction occurs first, then the myofibroblasts appear in the wound, and the collagen fibers are split and proliferated to form scars on collagen deposition.
Infection: If the wound is infected, on the one hand, the remaining epithelial cells are destroyed, so that the wound surface is deepened and the healing time is prolonged. On the other hand, the inflammatory factor stimulates the proliferation of fibroblasts, and the repeated infection causes the granulation tissue to hyperplasia. The infiltration of inflammatory cells makes the granulation tissue characteristic, and the infection causes the inflammatory cells to increase. The more fibroblasts, the more likely the scar hyperplasia occurs.
Local skin tension changes: the direction of the scar is inconsistent with the skin tension, leading to chronic traction, which is a factor of scar hyperplasia.
Age: Adolescents are in puberty, tissue growth is strong, the body's immune response after trauma, strong skin tension, prone to scar hyperplasia.
Pigment: There are many skin pigment cells in colored people, which are easy to cause scars. The incidence of black scars is about twice that of whites, and the incidence of burn scars in China is also quite high.
Surgery: If the surgical treatment of the scar body is stimulated, it will stimulate the fibroblasts, so that the scars will repeatedly proliferate. Therefore, if it is a scar, it should be strictly prohibited.
Others: Foreign body stimuli can also cause scar hyperplasia, common foreign objects are dust, talcum powder, cotton fiber, knots and so on.
Examine
an examination
In clinical patients who see scar hyperplasia, we must first see whether there is a history of trauma, history of infection, history of surgery, diagnosis based on clinical symptoms and signs; second, physical examination, according to the symptoms of scar hyperplasia, identify the depression Scars, superficial scars, scars and atrophy; if necessary, laboratory tests to determine the cause and severity of scar hyperplasia, to provide a basis for further treatment.
Diagnosis
Differential diagnosis
diagnosis:
Specific symptoms of scar
Scar tissue can have varying degrees of self-consciousness, which is most pronounced in hypertrophic scars. These symptoms include itching, stinging or burning, irritability or local hypersensitivity, and some patients may have obvious tenderness. Scars near the joints of the limbs can affect the movement of the limbs, leading to joint movement disorders; large areas of scars can cause the skin to lose its ability to perspire.
Characteristics of hypertrophic scars
In the early stage, the local scar is swollen and hardened, and most of them will not have serious functional disorders. At this time, the superficial scar, superficial layer, middle layer, bottom layer and basal layer are:
1. The surface layer is a layer of atrophic epithelial cells.
2. The middle layer is vasodilatation and has inflammatory cell infiltration.
3. The bottom layer is less collagen fibers and a large amount of connective tissue hyperplasia.
4. The basal layer does not adhere to deep tissues and can promote small shrinkage.
Differential diagnosis:
Scar formation: The formation of scars is caused by the body's inflammatory response, imbalance of collagen synthesis and degradation, the appearance of abnormal mucopolysaccharides, and the proliferation of fibroblasts. Reduced lymphatic drainage in hypertrophic scars, local edema, can lead to hypertrophy of scars, is an inevitable outcome of the body's wound repair.
Depressed scars: Defects in the dermis and subcutaneous tissue of the skin can cause depressed scars, often caused by hemorrhoids, trauma, and chickenpox.
Superficial scar: Superficial scar refers to a scar on the superficial layer of the skin, which is slightly different from normal skin and forms a skin infection.
Scar atrophy: Atrophic scar is a scar named after the dysfunction caused by it.
