Cutaneous fibrosis and normal wound healing

Abstract

Normal cutaneous wound healing is a highly orchestrated process requiring the participation of numerous cell types, each performing highly individualized functions at specific times under the guidance of dozens of circulating proteins that are themselves tightly controlled by transcriptional and translational mechanisms. It should come as no surprise that genetic and environmental perturbations could lead to the disruption of the successful completion of this process, or that the mechanisms themselves could be hijacked and diverted into the production of unnecessary scar. The first portion of this chapter introduces the cellular players in this drama, their normal roles in the maintenance of the extracellular matrix, and the overarching and coordinated production that is known as "normal" wound healing. The chapter culminates with the detailed examination of several cutaneous fibrosing processes that result when genetic and/ or environmental influences steer the mechanisms of wound healing and injury repair into "pathological" fibrosing disorders that can be notoriously challenging to correct.