Skip to main content
Top
Published in: Archives of Dermatological Research 2/2015

01-03-2015 | Original Paper

Clinical and epidemiological analysis of keloids in Chinese patients

Authors: Wen-sheng Lu, Xiao-dong Zheng, Xiu-hua Yao, Lan-fang Zhang

Published in: Archives of Dermatological Research | Issue 2/2015

Login to get access

Abstract

Keloids are common abnormally raised fibroproliferative lesions that can occur following even minor cutaneous trauma. There are limited data on Chinese patients with keloids, and the purpose of our study was to investigate the clinical and epidemiological features of keloids in Chinese patients. Assessment was performed by unified, designed questionnaires. A total of 715 patients were enrolled and statistical analysis and heritability were performed using EPI INFO 6.0, SPSS13.0 and Falconer’s method. Keloids occurred typically between the ages of 10 and 30 years, and the mean age of initial onset was 21.14 ± 13.45 years in females and 22.55 ± 11.36 years in males. The difference in the mean age of onset was not significant between males and females (p > 0.05). A greater severity of keloids was observed in the positive history family group than in the negative history family group, and this difference was statistically significant (χ 2 = 10.889, p < 0.05). The formation of keloids in multiple anatomical sites was found to be significant in the positive family history group. This difference was statistically significant (χ 2 = 15.47, p < 0.001). The prevalence of keloids in first-, second- and third-degree relatives of the proband with keloids was 7.62, 0.38 and 0.035 %, respectively. These results were higher than those in controls and the difference of the prevalence rates of first- and second-degree relatives between probands and controls was significant (χ 2 = 224.63 and 12.078, respectively, p < 0.001). The heritability of keloids in first-, second- and third-degree relatives was 72.45, 40.55 and 17.07 %, respectively. Our findings revealed that the most severe forms of keloids were observed in the probands with positive family history, and the heritability in first-degree relatives of probands was 72.45 %. It is certain, therefore, that genetic factors play a role in the hereditary composition of keloids.
Literature
1.
go back to reference Bayat A, Arscott G, Ollier WE, Ferguson MW, Mc Grouther DA (2004) Description of site-specific morphology of keloid phenotypes in an Afrocaribbean population. Br J Plast Surg 57(2):122–133CrossRefPubMed Bayat A, Arscott G, Ollier WE, Ferguson MW, Mc Grouther DA (2004) Description of site-specific morphology of keloid phenotypes in an Afrocaribbean population. Br J Plast Surg 57(2):122–133CrossRefPubMed
3.
go back to reference Bayat A, Arscott G, Ollier WE, McGrouther DA, Ferguson MW (2005) Keloid disease: clinical relevance of single versus multiple site scars. Br J Plast Surg 58(1):28–37CrossRefPubMed Bayat A, Arscott G, Ollier WE, McGrouther DA, Ferguson MW (2005) Keloid disease: clinical relevance of single versus multiple site scars. Br J Plast Surg 58(1):28–37CrossRefPubMed
4.
go back to reference Bock O, Schmid-Ott G, Malewski P, Mrowietz U (2006) Quality of life of patients with keloid and hypertrophic scarring. Arch Dermatol Res 297(10):433–438CrossRefPubMed Bock O, Schmid-Ott G, Malewski P, Mrowietz U (2006) Quality of life of patients with keloid and hypertrophic scarring. Arch Dermatol Res 297(10):433–438CrossRefPubMed
5.
go back to reference Bran GM, Goessler UR, Hormann K, Riedel F, Sadick H (2009) Keloids: current concepts of pathogenesis (review). Int J Mol Med 24(3):283–293CrossRefPubMed Bran GM, Goessler UR, Hormann K, Riedel F, Sadick H (2009) Keloids: current concepts of pathogenesis (review). Int J Mol Med 24(3):283–293CrossRefPubMed
6.
go back to reference Brissett AE, Sherris DA (2001) Scar contractures, hypertrophic scars, and keloids. Facial Plast Surg 17(4):263–272CrossRefPubMed Brissett AE, Sherris DA (2001) Scar contractures, hypertrophic scars, and keloids. Facial Plast Surg 17(4):263–272CrossRefPubMed
7.
go back to reference Brown BC, McKenna SP, Siddhi K, McGrouther DA, Bayat A (2008) The hidden cost of skin scars: quality of life after skin scarring. J Plast Reconstr Aesthet Surg 61(9):1049–1058CrossRefPubMed Brown BC, McKenna SP, Siddhi K, McGrouther DA, Bayat A (2008) The hidden cost of skin scars: quality of life after skin scarring. J Plast Reconstr Aesthet Surg 61(9):1049–1058CrossRefPubMed
8.
go back to reference Chipev CC, Simon M (2002) Phenotypic differences between dermal fibroblasts from different body sites determine their responses to tension and TGFbeta1. BMC Dermatol 2:13CrossRefPubMedCentralPubMed Chipev CC, Simon M (2002) Phenotypic differences between dermal fibroblasts from different body sites determine their responses to tension and TGFbeta1. BMC Dermatol 2:13CrossRefPubMedCentralPubMed
10.
go back to reference Davies DM (1985) Plastic and reconstructive surgery. Scars, hypertrophic scars, and keloids. Br Med J (Clin Res Ed) 290(6474):1056–1058CrossRef Davies DM (1985) Plastic and reconstructive surgery. Scars, hypertrophic scars, and keloids. Br Med J (Clin Res Ed) 290(6474):1056–1058CrossRef
11.
go back to reference Emery AEH (1986) Methodology in medical genetics. Churchill Livingston, New York Emery AEH (1986) Methodology in medical genetics. Churchill Livingston, New York
12.
13.
14.
16.
go back to reference Kischer CW, Shetlar MR, Chvapil M (1982) Hypertrophic scars and keloids: a review and new concept concerning their origin. Scan Electron Microsc Pt 4:1699–1713PubMed Kischer CW, Shetlar MR, Chvapil M (1982) Hypertrophic scars and keloids: a review and new concept concerning their origin. Scan Electron Microsc Pt 4:1699–1713PubMed
17.
go back to reference Louw L (2000) Keloids in rural black South Africans. Part 1: general overview and essential fatty acid hypotheses for keloid formation and prevention. Prostaglandins Leukot Essent Fatty Acids 63(5):237–245CrossRefPubMed Louw L (2000) Keloids in rural black South Africans. Part 1: general overview and essential fatty acid hypotheses for keloid formation and prevention. Prostaglandins Leukot Essent Fatty Acids 63(5):237–245CrossRefPubMed
18.
go back to reference Lu WS, Cai LQ, Wang ZX, Li Y, Wang JF, Xiao FL, Quan C, He SM, Yang S, Zhang XJ (2010) Association of HLA class I alleles with keloids in Chinese Han individuals. Hum Immunol 71(4):418–422CrossRefPubMed Lu WS, Cai LQ, Wang ZX, Li Y, Wang JF, Xiao FL, Quan C, He SM, Yang S, Zhang XJ (2010) Association of HLA class I alleles with keloids in Chinese Han individuals. Hum Immunol 71(4):418–422CrossRefPubMed
19.
go back to reference Marneros AG, Norris JE, Olsen BR, Reichenberger E (2001) Clinical genetics of familial keloids. Arch Dermatol 137(11):1429–1434CrossRefPubMed Marneros AG, Norris JE, Olsen BR, Reichenberger E (2001) Clinical genetics of familial keloids. Arch Dermatol 137(11):1429–1434CrossRefPubMed
20.
go back to reference Marneros AG, Norris JE, Watanabe S, Reichenberger E, Olsen BR (2004) Genome scans provide evidence for keloid susceptibility loci on chromosomes 2q23 and 7p11. J Invest Dermatol 122(5):1126–1132CrossRefPubMed Marneros AG, Norris JE, Watanabe S, Reichenberger E, Olsen BR (2004) Genome scans provide evidence for keloid susceptibility loci on chromosomes 2q23 and 7p11. J Invest Dermatol 122(5):1126–1132CrossRefPubMed
21.
go back to reference Nakashima M, Chung S, Takahashi A, Kamatani N, Kawaguchi T, Tsunoda T, Hosono N, Kubo M, Nakamura Y, Zembutsu H (2010) A genome-wide association study identifies four susceptibility loci for keloid in the Japanese population. Nat Genet 42(9):768–771CrossRefPubMed Nakashima M, Chung S, Takahashi A, Kamatani N, Kawaguchi T, Tsunoda T, Hosono N, Kubo M, Nakamura Y, Zembutsu H (2010) A genome-wide association study identifies four susceptibility loci for keloid in the Japanese population. Nat Genet 42(9):768–771CrossRefPubMed
22.
go back to reference Olaitan PB (2009) Keloids: assessment of effects and psychosocial-impacts on subjects in a black African population. Indian J Dermatol Venereol Leprol 75(4):368–372CrossRefPubMed Olaitan PB (2009) Keloids: assessment of effects and psychosocial-impacts on subjects in a black African population. Indian J Dermatol Venereol Leprol 75(4):368–372CrossRefPubMed
24.
go back to reference Phan TT, Lim IJ, Bay BH, Qi R, Longaker MT, Lee ST, Huynh H (2003) Role of IGF system of mitogens in the induction of fibroblast proliferation by keloid-derived keratinocytes in vitro. Am J Physiol Cell Physiol 284(4):C860–C869CrossRefPubMed Phan TT, Lim IJ, Bay BH, Qi R, Longaker MT, Lee ST, Huynh H (2003) Role of IGF system of mitogens in the induction of fibroblast proliferation by keloid-derived keratinocytes in vitro. Am J Physiol Cell Physiol 284(4):C860–C869CrossRefPubMed
25.
go back to reference Placik OJ, Lewis VL Jr (1992) Immunologic associations of keloids. Surg Gynecol Obstet 175(2):185–193PubMed Placik OJ, Lewis VL Jr (1992) Immunologic associations of keloids. Surg Gynecol Obstet 175(2):185–193PubMed
26.
go back to reference Ragoowansi R, Cornes PG, Moss AL, Glees JP (2003) Treatment of keloids by surgical excision and immediate postoperative single-fraction radiotherapy. Plast Reconstr Surg 111(6):1853–1859CrossRefPubMed Ragoowansi R, Cornes PG, Moss AL, Glees JP (2003) Treatment of keloids by surgical excision and immediate postoperative single-fraction radiotherapy. Plast Reconstr Surg 111(6):1853–1859CrossRefPubMed
27.
go back to reference Ramakrishnan KM, Thomas KP, Sundararajan CR (1974) Study of 1,000 patients with keloids in South India. Plast Reconstr Surg 53(3):276–280CrossRefPubMed Ramakrishnan KM, Thomas KP, Sundararajan CR (1974) Study of 1,000 patients with keloids in South India. Plast Reconstr Surg 53(3):276–280CrossRefPubMed
28.
go back to reference Seifert O, Mrowietz U (2009) Keloid scarring: bench and bedside. Arch Dermatol Res 301(4):259–272CrossRefPubMed Seifert O, Mrowietz U (2009) Keloid scarring: bench and bedside. Arch Dermatol Res 301(4):259–272CrossRefPubMed
29.
go back to reference Sharquie KE, Al-Dhalimi MA (2003) Keloid in Iraqi patients: a clinicohistopathologic study. Dermatol Surg 29(8):847–851PubMed Sharquie KE, Al-Dhalimi MA (2003) Keloid in Iraqi patients: a clinicohistopathologic study. Dermatol Surg 29(8):847–851PubMed
31.
32.
go back to reference Ud-Din S, Thomas G, Morris J, Bayat A (2013) Photodynamic therapy: an innovative approach to the treatment of keloid disease evaluated using subjective and objective non-invasive tools. Arch Dermatol Res 305(3):205–214CrossRefPubMed Ud-Din S, Thomas G, Morris J, Bayat A (2013) Photodynamic therapy: an innovative approach to the treatment of keloid disease evaluated using subjective and objective non-invasive tools. Arch Dermatol Res 305(3):205–214CrossRefPubMed
33.
go back to reference Urioste SS, Arndt KA, Dover JS (1999) Keloids and hypertrophic scars: review and treatment strategies. Semin Cutan Med Surg 18(2):159–171CrossRefPubMed Urioste SS, Arndt KA, Dover JS (1999) Keloids and hypertrophic scars: review and treatment strategies. Semin Cutan Med Surg 18(2):159–171CrossRefPubMed
Metadata
Title
Clinical and epidemiological analysis of keloids in Chinese patients
Authors
Wen-sheng Lu
Xiao-dong Zheng
Xiu-hua Yao
Lan-fang Zhang
Publication date
01-03-2015
Publisher
Springer Berlin Heidelberg
Published in
Archives of Dermatological Research / Issue 2/2015
Print ISSN: 0340-3696
Electronic ISSN: 1432-069X
DOI
https://doi.org/10.1007/s00403-014-1507-1

Other articles of this Issue 2/2015

Archives of Dermatological Research 2/2015 Go to the issue