scar atrophy
Introduction
Introduction The scar atrophy depression is a scar named after the dysfunction caused by it. Clinically common deformities caused by scar contracture include valgus valgus, lip valgus, chest-thoracic adhesion, hand scar contracture deformity, and flexion or extension of the joints. Among them, the cord-like scar contracture in the flexion of the joint, for a long time, the skin and subcutaneous tissue on both sides of the contracture scar can gradually elongate, becoming a scar-like scar contracture, called a scar contracture scar. Such large scars are common in the anterior neck, axillary fossa, elbow fossa, ankle joints, etc., and the smaller ones can be found in the medial malleolus, external malleolus, nasolabial fold, mouth, finger, etc. The opening of the body cavity is annular, causing its narrow diameter and affecting normal function.
Cause
Cause
Wound: In the process of wound healing, the inflammatory reaction occurs first, then the myofibroblasts appear in the wound, and the collagen fibers are split and proliferated to form scars on collagen deposition.
Infection: If the wound is infected, on the one hand, the remaining epithelial cells are destroyed, so that the wound surface is deepened and the healing time is prolonged. On the other hand, the inflammatory factor stimulates the proliferation of fibroblasts, and the repeated infection causes the granulation tissue to hyperplasia. The infiltration of inflammatory cells makes the granulation tissue characteristic, and the infection causes the inflammatory cells to increase. The more fibroblasts, the more likely the scar hyperplasia occurs.
Local skin tension changes: the direction of the scar is inconsistent with the skin tension, leading to chronic traction, which is a factor of scar hyperplasia.
Age: Adolescents are in puberty, tissue growth is strong, the body's immune response after trauma, strong skin tension, prone to scar hyperplasia.
Pigment: There are many skin pigment cells in colored people, which are easy to cause scars. The incidence of black scars is about twice that of whites, and the incidence of burn scars in China is also quite high.
Surgery: If the surgical treatment of the scar body is stimulated, it will stimulate the fibroblasts, so that the scars will repeatedly proliferate. Therefore, if it is a scar, it should be strictly prohibited.
Others: Foreign body stimuli can also cause scar hyperplasia, common foreign objects are dust, talcum powder, cotton fiber, knots and so on.
Examine
an examination
Related inspection
Skin lesion
In clinical patients who have seen scar atrophy, first of all, we must see whether there is a history of trauma, history of infection, history of surgery, diagnosis according to clinical symptoms and signs; second, physical examination, according to the symptoms of scar hyperplasia, identify the depression Sexual scars, superficial scars, scar hyperplasia; laboratory examination if necessary to determine the cause and severity of scar hyperplasia, to provide a basis for further treatment.
Diagnosis
Differential diagnosis
Differential diagnosis of scar atrophy:
First, hypertrophic scars
Such scars often occur after the wound healing of deep burns. Reticulated hypertrophic scars are also common in sutures around the skin after skin grafting of the III degree burn wound. In addition, the most common is that any incision scar after suturing is also included in this type.
Hypertrophic scars are characterized by prominent surfaces, irregular shapes, uneven heights, flushing and congestion, and firmness. It has a burning and itching sensation. Hypertrophic scars are manifested by increased ambient temperature, emotional agitation, or increased symptoms when eating spicy food. Hypertrophic scars often last for months or years before degenerative changes occur. The characteristics of this scar are: early local swelling and hard congestion, its tissue structure is covered by a layer of atrophic epithelial cells, the middle layer is vasodilatation, and there is inflammatory cell infiltration, the bottom layer is less collagen fiber and a large number Connective tissue hyperplasia. This scar is higher than the surface of the skin, with early local thickening and hardening, and capillary congestion is red or dark red. The base of the scar generally does not adhere to the deep tissue, can be pushed, and has less contractility, and most of them do not cause serious dysfunction, but affect the beauty in the face and exposed parts, so there is often a need for treatment.
Second, keloids
Keloid is a kind of connective tissue tumor on the skin. It is a scar characterized by persistent strong hyperplasia. It is often expressed as a crab-like infiltration of the surrounding skin. The lesion is raised from the skin and is uneven. The shape is irregular and the material is hard and tough. I feel a lot of itching.
Characteristics of keloids:
1. Systemic factors may play a major role, especially specific physical factors, which sometimes exhibit genetic characteristics. The keloids in these patients are often not related to the severity of skin damage, and even minor trauma, such as mosquito bites, vaccination and other needlestick injuries can form keloids.
2. Ethnic differences: According to statistical analysis, the incidence of keloids in dark-skinned people is 6-9 times higher. It may be related to the abnormal metabolism of melanocyte stimulating hormone.
3. Significantly good site: common in the sternum, shoulder triangle, auricle, lower jaw, upper back.
4. The lesion is long, and the growth is not degraded for many years. As the lesion progresses, the scar extends beyond the original base and gradually expands to the surrounding normal skin.
5. After simple surgical resection and suture treatment, it is easy to relapse, and the stronger the hyperplasia, the larger the area of the original scar, the faster the growth rate. Therefore, it can not be surgically removed.
