Scar Skin Research Articles

Standardization of color measurement in the medical photography in clinical practice

BACKGROUND: For many medical specialties, photography is a routine element of work. Environmental factors equally and significantly influence the interpretation of colour light perception and the quality of photographic recording. Standardization of conditions in medical photography is necessary for subsequent quantitative assessment of the postoperative skin scar by analysing colour coordinates in the RGB system. AIM: To determine the impact of illumination and shooting distance at colour coordinates when studying unaltered skin. METHODS: Five volunteers without any skin diseases and no make-up on their facial skin were taken in the study. Skin type by the Fitzpatrick scale was II–III. Digital photography was made with a mobile device camera at distance 30 cm from the subject. For each participant, a series of digital photographs was taken at a distance of 20, 30, 40, 50, 60, 70 cm from the light source. Colour coordinates in the RGB system were measured in the digital graphics editor Adobe Photoshop CS6. Statistical analysis of the obtained data was carried out using Microsoft Office Excel 2019, Phyton 3.11. RESULTS: The analysis of variance by the ANOVA method was used as a statistical analysis. In order to determine a statistically significant difference between the sets, Tukey HSD test was performed. A total of 1764 coordinates of three colours were subjected to statistical analysis (R=588, G=588, B=588). When constructing a heat map of the cross-correlation of the absolute values of each colour at each distance, taking into account the type of light source among themselves, the data had a strong direct correlation, regardless of the study area. When constructing a linear graph, coordinates of any of the zones were located on the same straight line. CONCLUSION: Photography conditions were experimentally determined under which the color interpretation of light is constant. Results of the study should be taken into account during medical photography and subsequent color assessment of postoperative skin scars.

Assessing the de novo assemblers: a metaviromic study of apple and first report of citrus concave gum-associated virus, apple rubbery wood virus 1 and 2 infecting apple in India

BackgroundThe choice of de novo assembler for high-throughput sequencing (HTS) data remains a pivotal factor in the HTS-based discovery of viral pathogens. This study assessed de novo assemblers, namely Trinity, SPAdes, and MEGAHIT for HTS datasets generated on the Illumina platform from 23 apple samples, representing 15 exotic and indigenous apple varieties and a rootstock. The assemblers were compared based on assembly quality metrics, including the largest contig, total assembly length, genome coverage, and N50.ResultsMEGAHIT was most efficient assembler according to the metrics evaluated in this study. By using multiple assemblers, near-complete genome sequences of citrus concave gum-associated virus (CCGaV), apple rubbery wood virus 1 (ARWV-1), ARWV-2, apple necrotic mosaic virus (ApNMV), apple mosaic virus, apple stem pitting virus, apple stem grooving virus, apple chlorotic leaf spot virus, apple hammerhead viroid and apple scar skin viroid were reconstructed. These viruses were further confirmed through Sanger sequencing in different apple cultivars. Among them, CCGaV, ARWV-1 and ARWV-2 were recorded from apples in India for the first time. The analysis of virus richness revealed that ApNMV was dominant, followed by ARWV-1 and CCGaV. Moreover, MEGAHIT identified novel single-nucleotide variants.ConclusionsOur analyses highlight the crucial role of assembly methods in reconstructing near-complete apple virus genomes from the Illumina reads. This study emphasizes the significance of employing multiple assemblers for de novo virus genome assembly in vegetatively propagated perennial fruit crops.

Surgical and Non-Surgical Approach for Tear Trough Correction: Fat Repositioning Versus Hyaluronic Acid Fillers

Objective: This paper compares two popular techniques for tear trough correction—fat repositioning and hyaluronic acid (HA) fillers—highlighting their efficacy, safety profiles, patient satisfaction, and associated complications. Methods: A narrative review of 20 studies comparing fat repositioning and HA fillers was conducted, focusing on parameters such as duration of results, volume restoration, complication rates, and patient satisfaction. Results: Fat repositioning provides long-lasting results but carries higher surgical risks compared with HA fillers. The transconjunctival approach is suitable for patients with minimal skin excess. The supraperiosteal plane allows for a quicker procedure and, despite postoperative edema and temporary irregular contouring, shows no difference in final cosmetic outcomes compared with other planes. Internal fixation reduces the risk of fat relapse and skin scarring but carries the risk of suboptimal positioning. HA fillers offer immediate, minimally invasive results but require periodic maintenance. The use of a cannula reduces the risk of vascular occlusion. Combining a high G’ filler for the midface with a low G’ with low hydrophilicity for the tear trough reduces the amount of filler needed and prolongs the results. Both surgical and non-surgical methods are effective, depending on patient needs and anatomical considerations. Conclusions: Fat repositioning is ideal for patients seeking long-term correction and are willing to undergo surgery, while HA fillers suit those preferring non-invasive treatments with customizable, short-term effects. Both techniques have pros and cons that must be matched to patient goals and conditions.

Caesarean scar endometriosis: how to make an accurate diagnosis.

Caesarean scar endometriosis is a rare condition characterised by the presence of endometrial tissue within a surgical scar following a caesarean section. A woman in her late 30s presented with a painful lump beneath her caesarean section skin scar, worsening during menstruation. Despite a previous incision and drainage procedure for a 'scar abscess', the symptoms persisted. Ultrasound imaging revealed a cystic lesion beneath the scar. A diagnosis of scar endometriosis was made, and surgical excision was performed. The patient remained symptom-free at 2-year follow-up postsurgery. Histopathology confirmed the presence of endometrial glands and stroma within the scar tissue. This case demonstrates that a reliable diagnosis of caesarean section endometriosis could be made with a triad of symptoms of a cyclic painful mass at the site of a caesarean section scar. Imaging is helpful in excluding other differential diagnoses. Diagnosis can be confirmed with histopathology and treated with complete surgical excision.

Dermal Microcoring for Skin Laxity, Rhytides, and Scars.

Dermal microcoring extracts cores of skin that are small enough to allow healing in a scarless fashion. Its use has been reported in the treatment of skin laxity, rhytides, and textural abnormalities. To report the authors' clinical experience using dermal microcoring in a variety of cases. A retrospective chart review was performed looking at dermal microcoring cases for any indication between August 2022 and March 2024. Thirty-eight patients were treated. Overall, 32 (84.2%) patients were women, with median age of 67 years (R: 20-80 years). Fitzpatrick skin types I to V were represented. Among patients with adequate photographs for review, improvements of grade 3 and 4 (good and excellent) were seen in 85.7% (n = 18/21) treated for skin laxity and rhytides, 50.0% (n = 3/6) treated for acne scars, 66.7% (n = 2/3) treated for traumatic or surgical scars, and 100.0% (n = 3/3) treated for foreign material. Six (15.4%) patients experienced erythema or hyperpigmentation lasting more than 4 weeks, and 2 (5.1%) patients experienced temporary focal scarring, which improved with intralesional therapy and laser treatment. No patients experienced permanent dyspigmentation, prolonged edema, or infection. Dermal microcoring has been demonstrated to safely and effectively treat skin laxity, rhytides, scars, and foreign material.

Systematic Review: Keloid and Hypertrophic Scar Management Updates

Keloids and hypertrophic scars pose significant challenges in clinical management due to their propensity for recurrence and their impact on patient’s quality of life. This systematic review evaluates the efficacy of various treatment modalities for these scars, with an emphasis on clinical outcomes, symptom alleviation, and recurrence rates. A comprehensive literature search identified studies published between 2014 and 2024, encompassing randomized controlled trials and observational studies. Results indicate that advanced therapies, such as botulinum toxin type A (BTX-A) and platelet-rich plasma (PRP), exhibit superior outcomes compared to traditional treatments, including triamcinolone acetonide (TAC), particularly concerning scar appearance and safety profiles. Furthermore, combination therapies, such as intralesional cryotherapy and CO2 fractional laser with intense pulsed light (IPL), demonstrated promising results in enhancing scar reduction and patient satisfaction. This review underscores the necessity of personalized treatment strategies tailored to individual patient requirements, taking into account factors such as scar characteristics and skin types. Future research should concentrate on optimizing treatment regimens to maximize efficacy while minimizing adverse effects, thereby ensuring long-term success in the management of keloids and hypertrophic scars.

Prevalence and Risk Factors of Surgical Site Infection Following Cesarean Section

Background: Surgical site infection (SSI) following Cesarean section (C-section) is a common cause of morbidity and imposes a significant load on the healthcare system. Therefore, the prevalence of factors that make individuals more susceptible to SSI after a C-section should be accurately assessed. Objectives: This study aimed to determine the frequency and risk factors for infection following C-section in women referred to the maternity ward of Ali ibn Abi Talib Hospital in Zahedan, Iran, from 2020 to 2022. Methods: This descriptive cross-sectional study was performed on all women admitted to the maternity ward of Ali ibn Abi Talib Hospital in Zahedan, whether undergoing elective or emergency C-sections. The patients were entered into the study with informed consent and were followed up to one month after surgery. Results: This study showed that approximately 5300 cases of C-sections were performed in Ali ibn Abi Talib Hospital during the mentioned period, of which 120 patients were referred to this hospital again because of surgical site infections. The occurrence of SSI in the present study was 2.26%, and obesity and anemia were identified as the predominant risk factors. The findings showed that the incidence of patients with SSI following a C-section with obesity, anemia, skin scar of previous C-section, rupture of membranes before C-section (> 6 hours), and diabetes mellitus were 80, 76.8, 36.7, 33.3, and 24.2 %, respectively. Conclusions: The recorded incidence of SSI following C-section was comparatively lower than findings from prior studies conducted in developing countries. Although the frequency of these complications is desirable, there are the same number of irreparable complications to mothers and infants and high costs for families and society.

Bromelain based enzymatic debridement in burn patients, its outcome, advantages and disadvantages

The aim of this study is to evaluate the outcomes, advantages, and disadvantages of bromelain-based enzymatic debridement in the management of burn wounds. Ours is a study in which we have selected 10 patients with deep dermal and full thickness burns admitted in SMS hospital, Jaipur. These patients underwent bromelain based enzymatic debridement applied as per the manufactures protocol. The patients were then observed for bromelain’s efficacy in debridement, wound healing, pain, duration of hospital stay, superadded bacteraemia and cosmetic outcome. Complete removal of burn eschar was observed in 9 out of 10 patients. Bromelain-based enzymatic debridement effectively removed necrotic tissue within a shorter timeframe compared to traditional methods. Patients treated with bromelain-based enzymatic debridement showed significantly faster wound healing, reduced infection rates, and lower pain levels during debridement. Improved cosmetic outcomes, such as reduced scarring and better skin texture, were also observed. Bromelain-based enzymatic debridement offers notable advantages in burn care, including expedited healing and enhanced patient comfort. Despite these benefits, the treatment's higher cost and the risk of allergic reactions are important considerations. The limited availability of bromelain-based products also poses a challenge. These factors suggest that while bromelain is a promising alternative, its use should be carefully evaluated based on individual patient needs and resource availability.

Characterization and Physiological Differences of Two Primary Cultures of Human Normal and Hypertrophic Scar Dermal Fibroblasts: A Pilot Study.

Background/Objectives: Dermal fibroblasts (DFs) are key participants in skin hypertrophic scarring, and their properties are being studied to identify the molecular and cellular mechanisms underlying the pathogenesis of skin scarring. Methods: In the present work, we performed a comparative analysis of DFs isolated from normal skin (normal dermal fibroblasts, NDFs), and hypertrophic scar skin (hypertrophic scar fibroblasts, HTSFs). The fibroblasts were karyotyped and phenotyped, and experiments on growth rate, wound healing, and single-cell motility were conducted. Results: Comparative analysis revealed a minor karyotype difference between cells. However, HTSFs are characterized by higher proliferation level and motility compared to NDFs. These significant differences may be associated with quantitative and qualitative differences in the cell secretome. A proteomic comparison of NDF and HTSF found that differences were associated with metabolic proteins reflecting physiological differences between the two cells lines. Numerous unique proteins were found only in the vesicular phase of vHTSFs. Some proteins involved in cell proliferation (protein-glutamine gamma-glutamyltransferase K) and cell motility (catenin delta-1), which regulate gene transcription and the activity of Rho family GTPases and downstream cytoskeletal dynamics, were identified. A number of proteins which potentially play a role in fibrosis and inflammation (mucin-5B, CD97, adhesion G protein-coupled receptor E2, antileukoproteinase, protein S100-A8 and S100-A9, protein caspase recruitment domain-containing protein 14) were detected in vHTSFs. Conclusions: A comparative analysis of primary cell cultures revealed their various properties, especially in the cell secretome. These proteins may be considered promising target molecules for developing treatment or prevention strategies for pathological skin scarring.

Association of Apple Scar Skin Viroid (ASSVd) Infection with an Emerging Disease in 'Saiwaihong' Apples.

A novel disease affecting small immature fruits has surfaced in 'Saiwaihong' apples (Malus pumila), a recently developed variety extensively cultivated across more than 20,000 ha in China. In an effort to pinpoint the causal agent(s) responsible for this ailment, RNA sequencing analysis was conducted on four symptomatic and four asymptomatic apple samples. The results revealed a diverse range of viruses and viroids, indicating mixed viral infection in diseased samples. However, a more focused examination involving 152 symptomatic and 122 asymptomatic fruit samples, using RT-PCR and dot-blotting hybridization techniques, highlighted a close association between the disease and the presence of apple scar skin viroid (ASSVd). Among the ASSVd variants obtained from diseased 'Saiwaihong' apples, 20 were identified, and they were either identical or closely related to isolates from various apple varieties cultivated in different regions and countries. This suggests that ASSVd isolates in 'Saiwaihong' might have been introduced from other apple varieties. Furthermore, the analysis indicates the possibility of two separate introductions, as the ASSVd 'Saiwaihong' isolates exhibited two distinct phylogenetic groups. These insights provide valuable guidance for disease control strategies and emphasize the significance of ongoing monitoring for ASSVd, both in its familiar forms and potential new variants.

Visible light accelerates skin wound healing and alleviates scar formation in mice by adjusting STAT3 signaling

During the wound healing process, the activation of signal transducer and activator of transcription 3 (STAT3) is considered crucial for the migration and proliferation of epithelial cells, as well as for establishing the inflammatory environment. However, an excessive STAT3 activation aggravates scar formation. Here we show that 450 nm blue light and 630 nm red light can differentially regulate the phosphorylation of STAT3 (p-STAT3) and its downstream cytokines in keratinocytes. Further mechanistic studies reveal that red light promotes wound healing by activating the PI3 kinase p110 beta (PI3Kβ)/STAT3 signaling axis, while blue light inhibits p-STAT3 at the wound site by modulating cytochrome c-P450 (CYT-P450) activity and reactive oxygen species (ROS) generation. In a mouse scar model, skin wound healing can be significantly accelerated with red light followed by blue light to reduce scar formation. In summary, our study presents a potential strategy for regulating epithelial cell p-STAT3 through visible light to address skin scarring issues and elucidates the underlying mechanisms.

The dual power of Alma Hybrid™: integrating ablative and non-ablative lasers for superior outcomes

The Alma Hybrid™ not only bridges the gap between traditional ablative and non-ablative laser treatments but also introduces enhanced transdermal delivery through the Impact Handpiece, utilising ultrasound technology. This integration allows for the effective treatment of a wide range of dermatological concerns, including scar revision, skin rejuvenation, and resurfacing ( Arellano-Huacuja, 2023 ; Arellano et al, 2023b ). This article aims to provide an examination of the clinical evidence supporting the Alma Hybrid™ system, with a focus on its integration into treatment plans for aesthetic and dermatological practices. Through an analysis of patient case studies and a review of the literature, this paper will demonstrate how the Alma Hybrid™ can be employed to enhance patient outcomes, particularly in challenging cases such as hypertrophic and atrophic scars. Furthermore, we will explore the system's efficacy across diverse patient demographics, with an emphasis on its safety profile in treating different Fitzpatrick skin types.

Evaluation of the efficacy, safety and satisfaction rates of platelet-rich plasma, non-cross-linked hyaluronic acid and the combination of platelet-rich plasma and non-cross-linked hyaluronic acid in patients with burn scars treated with fractional CO2 laser: A randomized controlled clinical trial.

Skin scarring can result from burns, injuries, stretch marks and acne, leading to cosmetic and functional difficulties. Treatments for burn scars encompass a range of options, such as lasers, corticosteroid injections, surgery and regenerative techniques such as platelet-rich plasma (PRP). Hyaluronic acid-based products offer skin hydration and shield against aging effects. A study is being conducted to evaluate how effective PRP injection, hyaluronic acid and their combination improve burn scars and their effects on quality of life and potential disabilities. In our study, PRP and non-cross-linked hyaluronic acid treatments were compared in 10 individuals with burn scars between 2022 and 2023. Patients received CO2 fractional laser treatment followed by injections in scar areas. Evaluations included the Vancouver scar scale (VSS), biometric assessments, ultrasounds and satisfaction ratings. Two therapy sessions were conducted at 1-month interval, and assessments were done before treatment, 1 month after the first session, and 3 months after the first session. Biometric assessments showed significant improvements in various parameters (tewametry, corneometry, erythema index, melanin index, cutometry, thickness and density) in the intervention groups compared to the placebo group (p <0.05). PRP-non-cross-linked hyaluronic acid, PRP and non-cross-linked hyaluronic acid treatments exhibited the best clinical responses with significant differences between groups (p <0.05). Dermal thickness did not show significant improvement during treatment sessions, and changes among subjects were not significantly different. The colorimetry parameter improved in all groups except the placebo group, with no significant difference between intervention groups. The VSS significantly decreased in all treatment groups except the placebo group. PRP, non-cross-linked hyaluronic acid and especially the combination of these two treatment options are very effective in treating burn scars.

Comparison of Normal Human Skin and Hypertrophic Scar Tissue Samples of Different Ages, Locations, and Stages of Maturity.

Scars disrupt the normal structure and function of the skin. The primary goal of plastic surgery is to prevent and reduce scarring. Therefore, we aimed to establish a comparison scheme between normal skin (NS) tissues of different ages and locations; hypertrophic scars (HTS) of different ages, locations, and maturities; and NS and HTS tissues to provide evidence on scar severity for improving treatment evaluation. Various methods including histology, immunohistochemistry, and immunofluorescence were employed to compare the general appearance, macrophage infiltration, fibroblast activity, degree of angiogenesis, and collagen fiber type and arrangement in human-sourced NS and HTS tissues of different ages, locations, and maturities in seven patients (three with NS and four with HTS) from the Department of Burn and Plastic Surgery of the Shandong Provincial Hospital from January 2019 to December 2020. The thicknesses of the epidermis and dermis of NS tissues varied with age and location. The epidermis of the upper arms, face, and upper eyelids of NS tissues sequentially thickened, whereas the dermis was sequentially thinner. Several glandular structures were identified in the upper eyelids but rarely in the face and upper arms. Histological changes in HTS tissue of different ages, locations, and maturity occur as scar formation time is prolonged, accompanied by increased CD86 levels and fibrosis. As the scar matured, connexin and VEGFR2 expression decreased, indicating reduced inflammation, fibroblast activity, and angiogenesis. The comparison between NS and HTS tissue also revealed significant differences; the positive expression of VEGFR2 and total collagen in HTS tissue was higher than that in NS tissue. We discovered significant differences among NS, HTS, and NS and HTS tissues of different ages, locations, and maturities. Further, this study may provide a basis for clarifying the treatment effect of different methods for HTS compared with those for NS, efficiently individualizing patients' treatment plans and ultimately shortening the scar treatment process.

Exosomes and microRNAs: insights into their roles in thermal-induced skin injury, wound healing and scarring.

A burn is a type of injury to the skin or other tissues caused by heat, chemicals, electricity, sunlight, or radiation. Burn injuries have been proven to have the potential for long-term detrimental effects on the human body. The conventional therapeutic approaches are not able to effectively and easily heal these burn wounds completely. The main potential drawbacks of these treatments include hypertrophic scarring, contracture, infection, necrosis, allergic reactions, prolonged healing times, and unsatisfactory cosmetic results. The existence of these drawbacks and limitations in current treatment approaches necessitates the need to search for and develop better, more efficient therapies. The regenerative potential of microRNAs (miRNAs) and the exosomal miRNAs derived from various cell types, especially stem cells, offer advantages that outweigh traditional burn wound healing treatment procedures. The use of multiple types of stem cells is gaining interest due to their improved healing efficiency for various applications. Stem cells have several key distinguishing characteristics, including the ability to promote more effective and rapid healing of burn wounds, reduced inflammation levels at the wound site, and less scar tissue formation and fibrosis. In this review, we have discussed the stages of wound healing, the role of exosomes and miRNAs in improving thermal-induced wounds, and the impact of miRNAs in preventing the formation of hypertrophic scars. Research studies, pre-clinical and clinical, on the use of different cell-derived exosomal miRNAs and miRNAs for the treatment of thermal burns have been documented from the year 2000 up to the current time. Studies show that the use of different cell-derived exosomal miRNAs and miRNAs can improve the healing of burn wounds. The migration of exosomal miRNAs to the site of a wound leads to inhibition of apoptosis, induction of autophagy, re-epithelialization, granulation, regeneration of skin appendages, and angiogenesis. In conclusion, this study underscores the importance of integrating miRNA and exosome research into treatment strategies for burn injuries, paving the way for novel therapeutic approaches that could significantly improve patient outcomes and recovery times.

A Strategy Involving Microporous Microneedles Integrated with CAR-TREM2-Macrophages for Scar Management by Regulating Fibrotic Microenvironment.

Dipeptidyl peptidase 4 (DPP4) positive fibroblasts play a pivotal role in scar development following skin injury. Heterogeneous vascular endothelial cells (ECs) within scarred areas retain the capacity to drive tissue regeneration and repair. Simultaneously, TREM2 macrophages play a crucial role in the progression and resolution of fibrosis by engaging in mutual regulation with ECs. However, effective strategies to inhibit scar formation through multi-factor regulation of the scar microenvironment remain a challenge. Here, CAR-TREM2-macrophages (CAR-TREM2-Ms) capable of targeting DPP4+ fibroblasts and modulating ECs subtype within the scar microenvironment are engineered to effectively prevent scarring. Hydrogel microporous microneedles (mMNs) are employed to deliver CAR-TREM2-Ms, which can effectively alleviate scar. Single-cell transcriptome sequencing (scRNA-seq) analysis reveals that CAR-TREM2-Ms can modify ECs fibrotic phenotype and regulate fibrosis by suppressing the profibrotic gene leucine-rich-alpha-2-glycoprotein 1 (Lrg1). In vitro experiments further demonstrate that CAR-TREM2-Ms improve the scar microenvironment by phagocytosing DPP4+ fibroblasts and suppressing TGFβ secretion. This, in turn, inhibits the phenotypic conversion of LRG1 ECs and provides multifactorial way of alleviating scars. This study uncovers the evidence that mMNs attached to CAR-TREM2-Ms may exert vital influences on skin scarring through the regulation of the skin scar microenvironment, providing a promising approach for treating posttraumatic scarring.

A Skin Stress Shielding Platform Based on Body Temperature-Induced Shrinking of Hydrogel for Promoting Scar-Less Wound Healing.

Stress concentration surrounding wounds drives fibroblasts into a state of high mechanical tension, leading to the delay of wound healing, exacerbating pathological fibrosis, and even causing tissue dysfunction. Here, an innovative skin stress-shielding hydrogel wound dressing is reported that makes the wound sites shrink as a response to body temperature and then remolds the stress micro-environment of wound sites to reduce the formation of skin scars. Composed of a modified natural temperature-sensitive polymer cross-linked with polyacrylic acid networks, this hydrogel wound dressing has demonstrated a substantial decrease in scar area for full-thickness wounds in rat models. The physical forces exerted by the wound dressing are instrumental in attenuating the activation and transduction of fibroblasts within the wound sites, thereby mitigating the excessive deposition of the extracellular matrix (ECM). Notably, the wound dressing significantly down-regulates the expression of transforming growth factor-β1(TGF-β1) and collagen I, while concurrently exerting a dramatic inhibitory effect on the integrin-focal adhesion kinase (FAK)/phosphorylated-FAK (p-FAK) signaling pathway. Collectively, the fabrication of functional hydrogels with a stress-shielding profile is a new route for achieving scar-less wound healing, thus offering immense potential for improving clinical outcomes and restoring tissue integrity.

Effects of low dose skin tissue derived peptides on the function and collagen expression of keloid fibroblasts

This study aims to investigate the effects of the skin tissue derived peptides on proliferation, apoptosis, migration and collagen expressions in keloid fibroblasts. From January 2015 to January 2017, patients with hypertrophic scar who underwent surgical excision in department of plastic surgery of Nanjing maternal and child health hospital were included in this retrospective study. Four peptides were selected from the differential peptides between human hypertrophic scar and normal skin tissue. They were named as peptide deregulated in hypertrophic scar 2-5 (PDHPS2-5). Bioinformatics and functional analysis were performed. A low dose of 10 μmol/L of four peptides were respectively added to the culture medium of human primary keloid fibroblasts for 24 h. Cell counting kit-8 (CCK-8) were used to detect the changes in cell viability. Cell apoptosis was detected by flow cytometry. Cell migration ability was checked by Transwell chamber. The protein expressions of collagen COL1A2 (Collagen type I alpha 2) and the myofibroblast marker gene ACTA2 (Actin alpha 2) were analyzed by Western blot. The results showed that bioinformatics prediction analysis revealed that peptide PDHPS4 has the longest half-life and the highest thermal stability. Compared with the control group, low dose of four peptides had no significant effect on the survival rate and apoptosis of keloid fibroblasts tested by CCK-8 assay and flowcytometry. Transwell analysis showed that one peptides (PDHPS5) can significantly inhibit the cell migration ability (The optical density value in Control is 0.81±0.11, in PDHPS5 is 0.27±0.03, t=8.61, P=0.001). Western blot analysis showed that four peptides (PDHPS2, PDHPS3, PDHPS4, PDHPS5) can significantly inhibit the protein expressions of COL1A2 (The relative protein band intensity in Control is 1.02±0.02, in PDHPS2 is 0.21±0.04, in PDHPS3 is 0.26±0.03, in PDHPS4 is 0.53±0.04, in PDHPS5 is 0.73±0.04, t=31.38, 38.54, 18.88, 11.07 respectively, all P value are less than 0.01). Three peptides (PDHPS2, PDHPS3, PDHPS5) can significantly inhibit the protein expressions of ACTA2 (The relative protein band intensity in Control is 1.02±0.02, in PDHPS2 is 0.64±0.05, in PDHPS3 is 0.77±0.06, in PDHPS5 is 0.47±0.07, t=12.08, 6.38, 14.06 respectively, all P value are less than 0.01). In conclusion, the differentially expressed peptides in human hypertrophic scar tissue can affect the function of keloid fibroblasts and collagen expressions to varying degrees. Among them, two peptides (PDHPS2,PDHPS3) significantly inhibit the protein expressions of COL1A2 and ACTA2. The peptide PDHPS5 has high stability, significantly suppresses cell migration, and reduces the protein expressions of COL1A2 and ACTA2, which may provide a new strategy for scar prevention and treatment.

Limited fasciectomy with versus without autologous adipose tissue grafting for treatment of Dupuytren’s contracture (REMEDY): study protocol for a multicentre randomised controlled trial

BackgroundDupuytren’s contracture is a hereditary disorder which causes progressive fibrosis of the palmar aponeurosis of the hand, resulting in digital flexion contractures of the affected rays. Limited fasciectomy is a standard surgical treatment for Dupuytren’s, and the one with the lowest recurrence rate; however, the recurrence is still relatively high (2–39%). Adipose-derived stem cells have been shown to inhibit Dupuytren’s myofibroblasts proliferation and contractility in vitro, as well as to improve scar quality and skin regeneration in different types of surgeries. Autologous adipose tissue grafting has already been investigated as an adjuvant treatment to percutaneous needle fasciotomy for Dupuytren’s contracture with good results, but it was only recently associated with limited fasciectomy. The purpose of REMEDY trial is to investigate if limited fasciectomy with autologous adipose tissue grafting would decrease recurrence compared to limited fasciectomy alone.MethodsThe REMEDY trial is a multi-centre open-label randomised controlled trial (RCT) with 1:1 allocation ratio. Participants (n = 150) will be randomised into two groups, limited fasciectomy with autologous adipose tissue grafting versus limited fasciectomy alone. The primary outcome is the recurrence of Dupuytren’s contracture on any of the treated rays at 2 years postoperatively. The secondary outcomes are recurrence at 3 and 5 years, scar quality, complications, occurrence of algodystrophy (complex regional pain syndrome), patient-reported hand function, and hypodermal adipose tissue loss at 1 year postoperatively in a small subset of patients.DiscussionThe REMEDY trial is one of the first studies investigating limited fasciectomy associated with autologous adipose tissue grafting for Dupuytren’s contracture, and, to our knowledge, the first one investigating long-term outcomes of this treatment. It will provide insight into possible benefits of combining adipose tissue grafting with limited fasciectomy, such as lower recurrence rate and improvement of scar quality.Trial registrationClinicalTrials.gov NCT05067764, June 13, 2022.

54481 A Comparative Analysis of CO2 Laser Therapy, RF Microneedling, TCA Cross, and Subcision on Post-Acne Boxcar Scarring in Skin of Color

54481 A Comparative Analysis of CO2 Laser Therapy, RF Microneedling, TCA Cross, and Subcision on Post-Acne Boxcar Scarring in Skin of Color