Finite Element Analysis of the Stress Changes Associated With the Growth of Acne Keloids
Background:. Almost half of all spontaneously occurring keloids are acne keloids on the anterior chest. These keloids often grow in a crab-claw shape due to predominant tractional stresses on the scar; such stresses are risk factors for keloid growth/progression. To understand the relationship betwe...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2024-12-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006365 |
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| author | Nobuaki Ishii, MD Satoshi Akaishi, MD, PhD Masataka Akimoto, MD, PhD Shizuko Ichinose, PhD Satoshi Usami, PhD Teruyuki Dohi, MD, PhD Rei Ogawa, MD, PhD, FACS |
| author_facet | Nobuaki Ishii, MD Satoshi Akaishi, MD, PhD Masataka Akimoto, MD, PhD Shizuko Ichinose, PhD Satoshi Usami, PhD Teruyuki Dohi, MD, PhD Rei Ogawa, MD, PhD, FACS |
| author_sort | Nobuaki Ishii, MD |
| collection | DOAJ |
| description | Background:. Almost half of all spontaneously occurring keloids are acne keloids on the anterior chest. These keloids often grow in a crab-claw shape due to predominant tractional stresses on the scar; such stresses are risk factors for keloid growth/progression. To understand the relationship between acne keloid growth and mechanical stress, we conducted finite element analysis (FEA), measured the long/short dimensions of photographed acne keloids, and subjected acne keloids to microscopy.
Methods:. FEA was conducted on 10 identically shaped ellipsoidal keloids whose long-axis length rose from 5 to 50 mm in 5-mm increments. They were embedded in the skin and subjected to traction. The stress on the keloid and its surrounding tissues was determined. Dimensions of 220 acne keloids were measured. Electron/light microscopy was conducted on the center, margins, and surrounding tissues of chest acne keloids.
Results:. FEA showed that as the keloid “grew,” the tractional stress centered on its core, then became evenly distributed, and then focused increasingly on the tractioned keloid margin, especially its shallow dermis. This is associated with increasing stress in the surrounding tissues at the keloid margin. Clinical dimension measurements showed that acne keloids remained round until 4–5 mm, after which they elongated rapidly. Electron microscopy showed that in the surrounding skin, fragments of keratinocyte, fibrin, and numerous cell fragments were observed just below the epidermal basement membrane.
Conclusions:. Keloid-prone acne should be treated with steroid tape or other keloid therapy when it reaches 4–5 mm in diameter. |
| format | Article |
| id | doaj-art-1a6206076b294b76bcb8b5fc754cb3dc |
| institution | OA Journals |
| issn | 2169-7574 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj-art-1a6206076b294b76bcb8b5fc754cb3dc2025-08-20T02:32:32ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742024-12-011212e636510.1097/GOX.0000000000006365202412000-00057Finite Element Analysis of the Stress Changes Associated With the Growth of Acne KeloidsNobuaki Ishii, MD0Satoshi Akaishi, MD, PhD1Masataka Akimoto, MD, PhD2Shizuko Ichinose, PhD3Satoshi Usami, PhD4Teruyuki Dohi, MD, PhD5Rei Ogawa, MD, PhD, FACS6From the * Department of Plastic Surgery, Nippon Medical School Chibahokusoh Hospital, Inzai City, Chiba Prefecture, Japan† Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School, Bunkyo Ward, Tokyo, JapanFrom the * Department of Plastic Surgery, Nippon Medical School Chibahokusoh Hospital, Inzai City, Chiba Prefecture, Japan† Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School, Bunkyo Ward, Tokyo, Japan§ Graduate School of Education, University of Tokyo, Bunkyo Ward, Tokyo, Japan† Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School, Bunkyo Ward, Tokyo, Japan† Department of Plastic, Reconstructive and Regenerative Surgery, Graduate School of Medicine, Nippon Medical School, Bunkyo Ward, Tokyo, JapanBackground:. Almost half of all spontaneously occurring keloids are acne keloids on the anterior chest. These keloids often grow in a crab-claw shape due to predominant tractional stresses on the scar; such stresses are risk factors for keloid growth/progression. To understand the relationship between acne keloid growth and mechanical stress, we conducted finite element analysis (FEA), measured the long/short dimensions of photographed acne keloids, and subjected acne keloids to microscopy. Methods:. FEA was conducted on 10 identically shaped ellipsoidal keloids whose long-axis length rose from 5 to 50 mm in 5-mm increments. They were embedded in the skin and subjected to traction. The stress on the keloid and its surrounding tissues was determined. Dimensions of 220 acne keloids were measured. Electron/light microscopy was conducted on the center, margins, and surrounding tissues of chest acne keloids. Results:. FEA showed that as the keloid “grew,” the tractional stress centered on its core, then became evenly distributed, and then focused increasingly on the tractioned keloid margin, especially its shallow dermis. This is associated with increasing stress in the surrounding tissues at the keloid margin. Clinical dimension measurements showed that acne keloids remained round until 4–5 mm, after which they elongated rapidly. Electron microscopy showed that in the surrounding skin, fragments of keratinocyte, fibrin, and numerous cell fragments were observed just below the epidermal basement membrane. Conclusions:. Keloid-prone acne should be treated with steroid tape or other keloid therapy when it reaches 4–5 mm in diameter.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006365 |
| spellingShingle | Nobuaki Ishii, MD Satoshi Akaishi, MD, PhD Masataka Akimoto, MD, PhD Shizuko Ichinose, PhD Satoshi Usami, PhD Teruyuki Dohi, MD, PhD Rei Ogawa, MD, PhD, FACS Finite Element Analysis of the Stress Changes Associated With the Growth of Acne Keloids Plastic and Reconstructive Surgery, Global Open |
| title | Finite Element Analysis of the Stress Changes Associated With the Growth of Acne Keloids |
| title_full | Finite Element Analysis of the Stress Changes Associated With the Growth of Acne Keloids |
| title_fullStr | Finite Element Analysis of the Stress Changes Associated With the Growth of Acne Keloids |
| title_full_unstemmed | Finite Element Analysis of the Stress Changes Associated With the Growth of Acne Keloids |
| title_short | Finite Element Analysis of the Stress Changes Associated With the Growth of Acne Keloids |
| title_sort | finite element analysis of the stress changes associated with the growth of acne keloids |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006365 |
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