Time to Change the Paradigm: Keloid Disorder as a Systemic Disease

BACKGROUND

Keloid is a skin disorder secondary to skin injury or inflammation. It often occurs in the face, chest, shoulder and ear and manifests as one or multiple local tumors. Many pathogenies have been proposed and far more methods have been used in keloid treatment.  Acknowledging pathologic background of this disease may influence treatment strategy and results.

METHODS

We carried out many studies in the view of patient immunology and gut bacterium these years. Many significant results were found. In this presentation, we summarize the results we have obtained and analyze their pathologic meaning of the disease.

RESULTS

Immunologic characters, skin bacteria and gut flora differences between keloid patients and healthy people were carried out. Immunologic change with CD8+ T lymphocyte and M1 macrophages aggregation were found in keloid tissue. Bacteria were found in keloid tissue. Compared with healthy people, Bifidobacterium adolescentis was characteristic microorganisms in gut flora in keloid patient. Taurochenodeoxycholic acid (TCDCA) may be the metabolite which influence keloid development. Gut-metabolite-scar axis may exist.

CONCLUSION

Based on these results, we think that keloid may not be a local disease, but a skin manifest of a system disorder. Methods should be explored which can re-balance the disordered system to reduce keloid recurrence.