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Hypertrophied scar and keloid.pptx

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Hypertrophied scar and keloid.pptx

  1. 1. Tips on using my ppt. 1. You can freely download, edit, modify and put your name etc. 2. Don’t be concerned about number of slides. Half the slides are blanks except for the title. 3. First show the blank slides (eg. Aetiology ) > Ask students what they already know about ethology of today's topic. > Then show next slide which enumerates aetiologies. 4. At the end rerun the show – show blank> ask questions > show next slide. 5. This will be an ACTIVE LEARNING SESSION x three revisions. 6. Good for self study also. 7. See notes for bibliography.
  2. 2. Phases of Healing
  3. 3. Phases of Healing • Inflammatory (Reactive) Haemostasis Inflammation • Proliferative (Regenerative/Reparative) Epithelial migration proliferation Maturation • Maturational (Remodeling) Contraction scarring Remodeling
  4. 4. Excessive Scar Formation
  5. 5. Excessive Scar Formation • Dense extracellular matrix consisting of collagen and glycosaminoglycans.
  6. 6. Definition
  7. 7. Definition • The keloid is defined as an abnormal scar that grows beyond the boundaries of the original site of skin injury. • The hypertrophic scar is defined as a widened or unsightly scar that does not extend beyond the original boundaries of the wound. • Unlike keloids, the hypertrophic scar reaches a certain size and subsequently stabilizes or regresses.
  8. 8. Epidemiology
  9. 9. Epidemiology • Keloids are seen with greater frequency in blacks, Hispanics, and Asians.
  10. 10. Sites
  11. 11. Sites • the sternum, deltoid region of the upper arm, and upper back, • earlobes, mandibular border, and posterior neck. • Trauma
  12. 12. Etiology and Pathophysiology
  13. 13. Etiology and Pathophysiology • Not known. • Numerous Theories- – allergic immunoglobulin E (IgE)–mediated response, – deficiency in melanocyte-stimulating hormone (MSH) metabolism or an excess of MSH . – microvascular occlusion and subsequent hypoxia
  14. 14. Etiology and Pathophysiology – interleukin-6 (IL-6) expression in the pathophysiology of keloids, and the role of insulinlike growth factor-1 (IGF-1) and IGF-1 receptor axis in the invasive activity of keloids. – ecause keloids are more prevalent in certain families and populations, genetic factors most likely impact keloid formation. Recently, DeltaNp63 overexpression and p53 underexpression have been identified in fibroblasts from keloids.[3]
  15. 15. Treatment & Management
  16. 16. Treatment & Management • surgical, • nonsurgical, and • ombined modality treatment.
  17. 17. Treatment :Surgical
  18. 18. Treatment :Surgical • simple excision, providing wound closure without undue tension. .
  19. 19. Treatment :Nonsurgical
  20. 20. Treatment :Nonsurgical • Pressure garments • injection of intralesional triamcinolone • Lasers, such as carbon dioxide, pulse dye, neodymium-yttrium aluminum garnet (Nd- YAG), and argon, • Various therapies, including nitrogen mustard, tetroquinone, antihistamines, retinoic acids, zinc, vitamin A, vitamin E, and verapamil • Interferon
  21. 21. Treatment :Combined modality
  22. 22. Treatment :Combined modality • laser-assisted skin healing (LASH). After excess hypertrophic scar tissue was removed, the authors applied laser irradiation followed with topical silicone gel sheeting for 2 months. Six months after revision, no recurrence of hypertrophic scarring was noted • cold-knife excision followed by postoperative injection of intralesional steroid.
  23. 23. Treatment :Combined modality •
  24. 24. Treatment :Combined modality • Cryosurgery • surgical excision and external beam radiotherapy
  25. 25. Get this ppt in mobile 1. Download Microsoft PowerPoint from play store. 2. Open Google assistant 3. Open Google lens. 4. Scan qr code from next slide.
  26. 26. Get this ppt in mobile
  27. 27. Get my ppt collection • https://www.slideshare.net/drpradeeppande/ edit_my_uploads • https://www.dropbox.com/sh/x600md3cvj8 5woy/AACVMHuQtvHvl_K8ehc3ltkEa?dl =0 • https://www.facebook.com/doctorpradeeppa nde/?ref=pages_you_manage

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