Hypertrophic Scar

Aka: Hypertrophic Scar

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II. Epidemiology

  1. Occurs in any race with any skin type (although occurs more commonly in darker skin)
    1. Contrast with Keloids which are far more common in darker skin
  2. Hypertrophic Scar has no genetic predisposition
    1. Contrast with Keloids

III. Pathophysiology

  1. Excessive fibroproliferative Collagen response to inflammation within the reticular Dermis
    1. Results in a scar formed from disorganized extracellular matrix
    2. More common in Trauma to skin in high tension regions
      1. Common skin injuries include Burn Injury, Lacerations, piercings, surgery
  2. Stages
    1. Stage 1: Inflammation occurs for up to first 10 days (with onset within 1 month of injury)
    2. Stage 2: Proliferation occurs over next 14 days
    3. Stage 3: Maturation and remodeling may continue for years

IV. Symptoms

  1. Lesions may cause local discomfort or Pruritus

V. Signs

  1. Characteristics
    1. Slightly raised or flat, pink to red lesions
  2. Isolated to site of Skin Injury
    1. Contrast with Keloid which extends beyond the scar
  3. Distribution
    1. Can occur anywhere, but have a predilection for extensor surfaces
  4. Timing
    1. Onset within 1 month of wound and regress and flatten with time

VI. Labs

  1. Biopsy Findings (if biopsied for other reasons)
    1. Fibroblasts increased
    2. Collagen fiber density increased

VII. Course

  1. Spontaneous regression over time as dermal irritation resolves

VIII. Management

  1. See Hypertrophic Scar Management

IX. Prevention

  1. See Keloid

X. References

  1. Bailey (2024) Am Fam Physician 110(6): 605-11 [PubMed]

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Related Studies

Ontology: Cicatrix, Hypertrophic (C0162810)

Definition (NCI) A permanent mark on the skin caused by deposits of excessive amounts of collagen during wound healing. It is elevated and does not extend beyond the original boundaries of the wound; the elevation may stabilize or regress spontaneously.(NICHD)
Definition (MSH) An elevated scar, resembling a KELOID, but which does not spread into surrounding tissues. It is formed by enlargement and overgrowth of cicatricial tissue and regresses spontaneously.
Concepts Acquired Abnormality (T020)
MSH D017439
ICD10 L91.0
SnomedCT 19843006, 201309001, 267821008
English Scars, Hypertrophic, Cicatrix, Hypertrophic, Cicatrices, Hypertrophic, Hypertrophic Cicatrices, Hypertrophic Cicatrix, Hypertrophic Scars, Scar, Hypertrophic, Hypertrophic scar of skin, hypertrophic scar, hypertrophic scar (diagnosis), Hypertrophic scarring, Cicatrix, Hypertrophic [Disease/Finding], hypertrophic scars, hypertrophic scarring, Hypertrophic cicatrix, Hypertrophic cicatrix (disorder), Hypertrophic: [cicatrix] or [scar] (disorder), Hypertrophic: [cicatrix] or [scar], Hypertrophic scars, Hypertrophic scar, Hypertrophic scar (disorder), hypertrophic; cicatrix, hypertrophic; scar, hypertrophy; scar, scar; hypertrophic, scar; hypertrophy, Hypertrophic Scar
Swedish Ärr, hypertrofiskt
Japanese ﾋｺｳｾｲﾊﾝｺﾝ, 過形成性瘢痕, 瘢痕-肥厚性, 肥厚性瘢痕, 瘢痕-過形成性
Czech jizva hypertrofická, Hypertrofická jizva
Finnish Hypertrofinen arpi
Russian RUBETS GIPERTROFICHESKII, RUBTSOVAIA TKAN' GIPERTROFIROVANNAIA, РУБЕЦ ГИПЕРТРОФИЧЕСКИЙ, РУБЦОВАЯ ТКАНЬ ГИПЕРТРОФИРОВАННАЯ
Italian Cicatrici ipertrofiche, Cicatrice ipertrofica
Latvian Hipertrofiskā rēta, Rēta, hipertrofiskā
Polish Blizna przerostowa, Blizna przerosła
Spanish cicatriz hipertrófica de la piel, cicatriz hipertrófica, cicatriz hipertrófica (trastorno), cicatriz hipertrófica de la piel (trastorno), Cicatriz hipertrófica, Cicatriz Hipertrófica, Escaras Hipertróficas
Hungarian Hypertrophiás heg
Norwegian Hypertrofiskt arr, Arr, hypertrofiske
Dutch hypertrofie; litteken, hypertrofisch; litteken, litteken; hypertrofie, litteken; hypertrofisch, hypertrofisch lidteken, Hypertrofisch litteken, Litteken, hypertrofisch
Portuguese Cicatriz hipertrofica, Cicatriz Hipertrófica, Escaras Hipertróficas
German hypertrophische Narbe, Narbe, hypertrophe, Narben, hypertrophische
French Cicatrice hypertrophique
Derived from the NIH UMLS (Unified Medical Language System)

Related Topics in Hyperplastic Skin Disorders

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