Keloid associated with hypertension

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Keloids (n=5). Intervention: Three-dimensional photoacoustic imaging (PAI). Primary outcome: Correlation between increase in keloid height (recurrence) and presence of hyperoxic superficial vessels on PAI (rs = 0.860, p=0.002).

JosephM. Zmuda; P D Thompson

doi:10.1016/s0140-6736(96)90042-2

February 1, 1996The Lancet

Keloid associated with hypertension

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Key result

Hyperoxic superficial microvessels on photoacoustic imaging strongly correlate with local keloid recurrence.

rs = 0.860
P=0.002
n=5

Key Points

To characterize longitudinal microvascular architecture and oxygenation dynamics in regressing and recurrent keloids using photoacoustic and ultrasound imaging.
Enrolled 5 patients (4 men, 1 woman; median age, 39 years [IQR, 21–59]) with 6 keloids between December 2022 and July 2023.
Conducted serial cross-sectional 3D ultrasound and photoacoustic imaging across baseline (T0), 1 month (T1), 3 months (T3), and 6 months (T6).
Quantified layer-specific superficial microvessels and subdermal venous networks alongside relative oxygen saturation (S-factor).
Two keloids regressed, showing progressive flattening, decreased superficial vessel density, and persistently low oxygen saturation in superficial vessels.
Four keloids recurred between T3 and T6, characterized by the emergence of superficial microvessels with elevated S-factors continuous with subdermal venous networks.
Intersession stability of the S-factor in peri-keloid reference regions demonstrated a mean CV of 4.0% (range, 0.5–6.7%) and an ICC of 0.70.

Study Design

Type

Observational (n=5)

Multicenter

No

Structured PICO

P

Population

5 adult patients (median age 39, 20% female) with 6 keloids undergoing conservative treatment were followed for up to 6 months using 3D photoacoustic imaging.

E

Exposure

Three-dimensional photoacoustic imaging (PAI) using dual-wavelength excitation (756 nm and 797 nm) and 3D ultrasound (3DUS) assessments at baseline and 1, 3, and 6 months following conservative treatment (local triamcinolone injections).

O

Outcome

Longitudinal layer-specific vascular and oxygenation changes (relative S-factor values) associated with local keloid recurrencesurrogate

Main Result

Effect estimate: rs = 0.860

p-value: p=0.002

Three-dimensional photoacoustic imaging demonstrates that the emergence of hyperoxic superficial microvessels precedes morphological local keloid recurrence, indicating its potential as an imaging biomarker.

Limitations

Small sample size and lack of stratification by demographic and lesion-specific factors
Limited sample size precluded comparative analysis of temporal changes in relative S-factor values between recurrence and regression groups
The 6-month observation period may not capture the full course of keloid progression
Spatial resolution of the PAI system limited the evaluation of finer capillary structures
Manual segmentation of the superficial layer may affect reproducibility
Lack of calibration against an absolute oxygenation reference
Exploratory study not intended to evaluate treatment efficacy
Sample size estimation based on statistical power was not performed (small sample size)

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Implication

Should not alter keloid management; leaves open whether hyperoxic microvessels predict recurrence in prospective studies.

Abstract

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Cite This Study

Zmuda et al. (1996) conducted an observational in Keloids (n=5). Three-dimensional photoacoustic imaging (PAI) was evaluated on Correlation between increase in keloid height (recurrence) and presence of hyperoxic superficial vessels on PAI (rs = 0.860, p=0.002). The emergence of hyperoxic superficial microvessels detected by three-dimensional photoacoustic imaging was strongly correlated with local keloid recurrence (rs = 0.860).

synapsesocial.com/papers/6ad10f3cf6156e245629bc38 https://doi.org/10.1016/s0140-6736(96)90042-2

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Keloid associated with hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keloid associated with hypertension

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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