Are symptoms in pathologic scars related to nerve function or density? A scoping review

IF 3.2 3区医学 Q2 CRITICAL CARE MEDICINE Burns Pub Date : 2024-10-10 DOI:10.1016/j.burns.2024.10.001

M. De Henau , S. Schins , C. Colla , E. van den Kerckhove , R. van der Hulst , S. Tuinder

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Abstract

Background

Hypertrophic scars and keloids are forms of pathologic scarring that can give rise to pain and pruritus. The link between nerve function and nerve density and the symptoms in pathologic scars (PS) remains unclear.

Objective

We aim to assess current knowledge on nerve function and nerve density in PS, and to explore a possible association between alterations in sensibility/nerve density and pathologic scar symptoms.

Methods

A scoping review was conducted. After performing a systematic search using PubMed, Embase and Web-of-Science, relevant papers were selected and analyzed by 2 reviewers. Data was charted in tables in combination with a narrative summary of main findings.

Results

Nineteen studies were included. Overall, functional sensibility in PS seems disturbed, with a higher frequency of allodynia and altered thermosensory thresholds, suggesting involvement of small fiber neuropathy. Nerve fiber density varied with the investigated skin layer and the used staining techniques, which implied limitations to compare findings from different studies. However, evidence suggests involvement of neuropeptides in the pathologic scar formation and symptomatology.

Conclusions

Wide heterogeneity between studies exists. Therefore, no firm conclusions can be formulated. However, evidence suggests involvement of the cutaneous nervous system by neurogenic inflammation in the pathophysiology of pathologic scars and their symptoms.

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病理性疤痕的症状与神经功能或密度有关吗？范围综述。

背景：肥厚性疤痕和瘢痕疙瘩是病理性疤痕的一种，可引起疼痛和瘙痒。神经功能和神经密度与病理性疤痕（PS）症状之间的联系仍不清楚：我们旨在评估目前有关 PS 神经功能和神经密度的知识，并探讨感觉性/神经密度的改变与病理性疤痕症状之间可能存在的联系：方法：我们进行了范围审查。在使用PubMed、Embase和Web-of-Science进行系统性检索后，筛选出相关论文并由两名审稿人进行分析。结果：共纳入 19 项研究：结果：共纳入 19 项研究。总体而言，PS 患者的功能感受性似乎受到干扰，异动症和热感阈值改变的频率较高，这表明小纤维神经病变的参与。神经纤维密度因所研究的皮肤层和所使用的染色技术而异，这意味着对不同研究结果进行比较存在局限性。不过，有证据表明，神经肽参与了病理性疤痕的形成和症状：结论：不同研究之间存在广泛的异质性。结论：不同研究之间存在广泛的异质性，因此无法得出确切的结论。不过，有证据表明，神经源性炎症导致的皮肤神经系统参与了病理性疤痕及其症状的病理生理学过程。

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来源期刊

Burns 医学-皮肤病学

CiteScore

4.50

自引率

18.50%

发文量

304

审稿时长

72 days

期刊介绍： Burns aims to foster the exchange of information among all engaged in preventing and treating the effects of burns. The journal focuses on clinical, scientific and social aspects of these injuries and covers the prevention of the injury, the epidemiology of such injuries and all aspects of treatment including development of new techniques and technologies and verification of existing ones. Regular features include clinical and scientific papers, state of the art reviews and descriptions of burn-care in practice. Topics covered by Burns include: the effects of smoke on man and animals, their tissues and cells; the responses to and treatment of patients and animals with chemical injuries to the skin; the biological and clinical effects of cold injuries; surgical techniques which are, or may be relevant to the treatment of burned patients during the acute or reconstructive phase following injury; well controlled laboratory studies of the effectiveness of anti-microbial agents on infection and new materials on scarring and healing; inflammatory responses to injury, effectiveness of related agents and other compounds used to modify the physiological and cellular responses to the injury; experimental studies of burns and the outcome of burn wound healing; regenerative medicine concerning the skin.