Keloids and Hypertrophic Scars: Characteristic Vascular Structures Visualized by Using Dermoscopy
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Background: Keloids and hypertrophic scars representexcessive scarring. They require different therapeutic approaches,which can be hampered because of an apparent lackof morphologic difference between the two diseases. Objective: This study investigated the clinical and dermoscopicfeatures of keloids and hypertrophic scars in order tohelp dermatologists distinguish these lesions better. Methods: A total of 41 keloids and hypertrophic scars in 41patients were examined clinically and by performingdermoscopy with a digital imaging system. Lesions wereevaluated for vascular structures. Results: Dermoscopyrevealed vascular structures in most keloid lesions (90%) butin only 27% of hypertrophic scar lesions. The most commondermoscopic vascular structures in keloids were arborizing(52%), followed by linear irregular (33%) and commashaped(15%); these features were present but less evident inhypertrophic scars (9% for all types). The distributionfrequency of the vascular structures differed significantlybetween diseases (p＜0.001). Conclusion: A strong associationof vascular structures with keloids was observed ondermoscopic examination. The results suggest dermoscopicexamination of vascular structures is a clinically usefuldiagnostic tool for differentiating between keloids andhypertrophic scars.
Abstract
Background: Keloids and hypertrophic scars representexcessive scarring. They require different therapeutic approaches,which can be hampered because of an apparent lackof morphologic difference between the two diseases. Objective: This study investigated the clinical and dermoscopicfeatures of keloids and hypertrophic scars in order tohelp dermatologists distinguish these lesions better. Methods: A total of 41 keloids and hypertrophic scars in 41patients were examined clinically and by performingdermoscopy with a digital imaging system. Lesions wereevaluated for vascular structures. Results: Dermoscopyrevealed vascular structures in most keloid lesions (90%) butin only 27% of hypertrophic scar lesions. The most commondermoscopic vascular structures in keloids were arborizing(52%), followed by linear irregular (33%) and commashaped(15%); these features were present but less evident inhypertrophic scars (9% for all types). The distributionfrequency of the vascular structures differed significantlybetween diseases (p＜0.001). Conclusion: A strong associationof vascular structures with keloids was observed ondermoscopic examination. The results suggest dermoscopicexamination of vascular structures is a clinically usefuldiagnostic tool for differentiating between keloids andhypertrophic scars.
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