An overview of biological basis of pathologic scarring.

AIMS AND

OBJECTIVES

To review the current mechanisms and biologic processes leading to the formation of pathologic scars.

MATERIALS AND

METHODS

A computerised literature search was carried out using MEDLINE for all published articles on ''pathologic scarring''. The medical subject headings ''scarring'' were combined with ''mechanisms''. A review of selected relevant literature was then undertaken.

RESULTS

Scarless embryonal healing tends to be characterised by minimal inflammatory reaction mediated by reduced IL6,IL8 and hyaluronidase while there are elevated levels of hyaluronic acid MMP1to3, as well as IL10.The multifunctional cytokine TGF-B, its several isoforms as well as its postreceptor signalling mechanisms appears to play the key role in the scarring process . There is also evidence to show that PDGF, IGF and other cytokines regulate scarring . While conventional antiscarring agents target the fibroplasia phase, others such as tamoxifen ,calcium channel blockers, and imidazolaquinolines targets various phases of the scarring process .

CONCLUSION

It appears that multiple mechanisms are involved in the phenotypical appearance of abnormal scarring. A deeper understanding of these mechanisms is pivotal to the development of better antiscarring therapies in the very near future .