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Updated: Aug 30, 2025

Isolation, Culture, and Characterization of Primary Dermal Fibroblasts from Human Keloid Tissue
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Keloid Nodule Metabolic Activity for Continuous Expansion.

Koichi Ueda1, Yuumi Lee1, Yosuke Inomata2

  • 1Department of Plastic and Reconstructive Surgery, Osaka Medical and Pharmaceutical University, Osaka, Japan.

Plastic and Reconstructive Surgery. Global Open
|August 29, 2022
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Summary

Keloid nodules grow by increasing in number and total area, not size. This suggests their crucial role in metabolic activity and continuous expansion of keloid lesions.

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Area of Science:

  • Dermatology
  • Pathology
  • Cell Biology

Background:

  • Keloid nodules exhibit distinct structures with higher autophagy protein and glycolytic marker expression in central fibroblasts compared to marginal fibroblasts.
  • Previous research indicated structural specificities within keloid nodules.

Purpose of the Study:

  • To investigate the role of keloid nodules in metabolic activity driving continuous keloid expansion.
  • To understand the growth mechanisms of keloid nodules over time.

Main Methods:

  • Analysis of 57 keloid nodules from seven samples, categorized by disease duration (2, 4, 6, 17 years).
  • Utilized immunohistochemical and immunofluorescent analyses, including anti-CD-31 staining.
  • Quantified fibroblast density and nodule/dermis area ratios.

Main Results:

  • Keloid nodules showed significantly higher fibroblast density than surrounding connective tissue (P < 0.05).
  • Nodule vascularity was greater in the marginal zone compared to the central zone.
  • The ratio of total nodule area to dermis area increased with disease duration, peaking at 48.01% in the 17-year group.

Conclusions:

  • Keloid growth occurs through an increase in nodule number and total area, rather than individual nodule enlargement.
  • Keloid nodules are crucial for energy metabolism, facilitating continuous keloid expansion.