Keloids emerge when normal wound healing is disturbed. Although much is known about the pathogenesis, the reasons for induction of keloids still remain unclear.
“Normal wound healing is like a good story: there is a beginning, a middle, and an end,” Prof. Greg Goodman (Monash University, Australia) began his lecture . Normal wound healing starts with an inflammatory phase (see Figure), with activation of the clotting cascade as well as action of cytokines and the attraction of immune cells. Next is the proliferative phase, which lasts for about 6-7 weeks. The fibrin plug is replaced by granulation tissue, fibroblasts generate collagen 3, extracellular matrix and re-epithelialisation takes place as keratinocytes migrate across the wound surface. Angiogenesis also induces the production of immature leaky blood vessels to allow easy access of nutrients. During the final remodelling phase, the granulation tissue changes from type 3 collagen to type 1, the i...
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