Hypertrophic Scar

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
Hypertrophic Scar has no genetic predisposition
1. Contrast with Keloids

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
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

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

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