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Keloid og hypertrofisk arrdanning

Sist revidert:
Sist revidert av:


Definisjon:
Hypertrofiske arr er fortykket arrdanning innenfor grensene til den primære skaden. Slike vevsdannelser går ofte tilbake over tid
Forekomst:
Opptrer 5-15 ganger hyppigere hos mørkhudete personer, hvor insidensen blir angitt til mellom 4,5% og 16%
Symptomer:
Tidligere traume, akne, ørepiercing, vannkopper, vaksinasjoner, biopsiprosedyrer er de vanligste disponerende hendelsene
Funn:
Det kan være vanskelig å skille normal arrdanning fra hypertrofisk, og lesjonen kan ofte inneholde begge tilstandene
Diagnostikk:
Ingen tilleggsundersøkelser er nødvendige
Behandling:
Ved keloid og hypertrofisk arr foreligger det flere behandlingsalternativer: trykk, silikon, medikament, kirurgi
  1. Lee HJ, Jang YJ. Recent Understandings of Biology, Prophylaxis and Treatment Strategies for Hypertrophic Scars and Keloids. Int J Mol Sci. 2018;19(3):711. Published 2018 Mar 2. PMID: 29498630 PubMed  
  2. Wang ZC, Zhao WY, Cao Y, et al. The Roles of Inflammation in Keloid and Hypertrophic Scars. Front Immunol. 2020;11:603187. Published 2020 Dec 4. PMID: 33343575 PubMed  
  3. Juckett G, Hartman-Adams H. Management of keloids and hypertrophic scars. Am Fam Physician 2009; 80: 253-60. American Family Physician  
  4. Kokoska MS. Hypertrophic scarring and keloids. Medscape, last updated Aug 08, 2018. emedicine.medscape.com  
  5. Robles DT, Berg D. Abnormal wound healing: keloids. Clin Dermatol 2007; 25:26. PubMed  
  6. Berman B, Perez OA, Konda S, et al. A review of the biologic effects, clinical efficacy, and safety of silicone elastomer sheeting for hypertrophic and keloid scar treatment and management. Dermatol Surg 2007; 33: 1291–1303. PMID: 17958580 PubMed  
  7. Mahdavian Delavary B, van der Veer WM, Ferreira JA, Niessen FB. Formation of hypertrophic scars: evolution and susceptibility. J Plast Surg Hand Surg 2012; 46:95. PubMed  
  8. De Felice B, Ciarmiello LF, Mondola P, Damiano S, Seru R, Argenziano C, et al. Differential p63 and p53 expression in human keloid fibroblasts and hypertrophic scar fibroblasts. DNA Cell Biol. Aug 2007. 26(8):541-7. PMID: 17688405 PubMed  
  9. Ogawa R, Okai K, Tokumura F, Mori K, Ohmori Y, Huang C, et al. The relationship between skin stretching/contraction and pathologic scarring: the important role of mechanical forces in keloid generation. Wound Repair Regen. 2012 Mar-Apr. 20(2):149-57. PMID: 22332721 PubMed  
  10. Anzarut A, Olson J, Singh P, et al. The effectiveness of pressure garment therapy for the prevention of abnormal scarring after burn injury: a meta-analysis. J Plast Reconstr Aesthet Surg 2009; 62:77. PubMed  
  11. Sarrazy V, Billet F, Micallef L, et al. Mechanisms of pathological scarring: role of myofibroblasts and current developments. Wound Repair Regen 2011; 19 Suppl 1:s10. PMID: 21793960 PubMed  
  12. Atiyeh B.S. Nonsurgical management of hypertrophic scars: Evidence-based therapies, standard practices, and emerging methods. Aesthet. Plast. Surg. 2007;31:468–492. PMID: 17576505 PubMed  
  13. Gold MH, McGuire M, Mustoe TA, et al. Updated international clinical recommendations on scar management: part 2--algorithms for scar prevention and treatment. Dermatol Surg. 2014;40(8):825-831. PubMed  
  14. O'Brien L, Jones DJ. Silicone gel sheeting for preventing and treating hypertrophic and keloid scars. Cochrane Database of Systematic Reviews 2013, Issue 9. Art. No.: CD003826. DOI: 10.1002/14651858.CD003826.pub3. DOI  
  15. Jiang Q, Chen J, Tian F, Liu Z. Silicone gel sheeting for treating hypertrophic scars. Cochrane Database of Systematic Reviews 2021, Issue 9. Art. No.: CD013357. DOI: 10.1002/14651858.CD013357.pub2. Accessed 11 October 2021. The Cochrane Library  
  16. Lumenta DB, Siepmann E, Kamolz LP. Internet-based survey on current practice for evaluation, prevention, and treatment of scars, hypertrophic scars, and keloids. Wound Repair Regen 2014; 22:483. PubMed  
  17. Robles D.T., Berg D. Abnormal wound healing: Keloids. Clin. Dermatol. 2007;25:26–32. PMID: 17276198 PubMed  
  18. Lee SY, Park J. Postoperative electron beam radiotherapy for keloids: treatment outcome and factors associated with occurrence and recurrence. Ann Dermatol 2015; 27:53. PubMed  
  19. Jin R, Huang X, Li H, et al. Laser therapy for prevention and treatment of pathologic excessive scars. Plast Reconstr Surg 2013; 132:1747. PubMed  
  • Terje Johannessen, professor i allmennmedisin, Trondheim

Tidligere fagmedarbeidere

  • Kim Alexander Tønseth, Plastisk kirurgisk avdeling, Rikshospitalet, Oslo