Hypertrophic or keloid scars?

Abstract

Further attempts to achieve a clinical distinction between hypertrophic and keloid scars seem pointless. Research in recent years has shifted from the extracellular components towards the cells themselves. Much more work needs to be done to characterise the activities of the various cell lines and the mechanisms of their control. A key question is whether the cells are due to a different subpopulation of fibroblasts or whether they are normal wound-healing cells acting under some chemical or physical influence. Ultimately, most hypertrophic and keloid scars become flat and pale, although the time sequence is very variable and there is little understanding of the process of scar maturation. Meanwhile, the problem remains as a significant cause of human suffering deserving further investment of time and resources. © 1994 Royal College of Ophthalmologists.