Insights from comparing blood perfusion metrics and Vancouver Scar Scale in keloid assessment

Keloids are pathological scars characterized by excessive fibroproliferation that extend beyond the boundaries of the original wound. Their assessment and treatment remain challenging due to variability in severity and response to interventions. Current evaluation methods, such as the Vancouver Scar Scale (VSS), rely heavily on subjective observation, which can limit consistency and accuracy. Laser Speckle Contrast Imaging (LSCI) has emerged as an objective tool capable of evaluating keloid vascularity by assessing blood perfusion. This retrospective study analyzed 176 keloid lesions from 99 patients to explore the utility of LSCI in assessing keloid severity and monitoring treatment outcomes. Changes in blood perfusion (PU) ratios derived from LSCI (PU_{keloid/control}) before and after treatment were compared the corresponding pre- and post-treatment VSS scores. The results demonstrated a significant correlation between PU_{keloid/control} and VSS (ρ = 0.308, p < 0.001), with linear regression showing an association between decreases in perfusion ratio and reductions in VSS (R² = 0.539, p < 0.01). Clinical cases demonstrated that PU_{keloid/control} effectively identifies high-perfusion areas, guiding targeted interventions and improving treatment precision. The results suggest LSCI provides an objective, non-invasive method to assess keloid vascularity, complementing traditional tools to enhance scar evaluation and treatment planning.