Insights Into Demographics, Comorbidities, and Risk Factors in Keloids and Hypertrophic Scars: A Retrospective Study.

Abstract

Hypertrophic scars and keloids represent abnormal wound healing, manifesting as raised scars confined to or extending beyond the wound margin, respectively. Understanding the risk factors associated with these scarring types is crucial for prevention and management. Utilizing the TriNetX global health research network database, we analyzed the data of 6,249 patients with hypertrophic scars or keloids. We employed the ICD-10 code L91.0 for identification, generating a control cohort matched by age, sex, and race. Associations between scarring and race, ethnicity, and various comorbidities were quantified. The analysis revealed that hypertrophic scars and keloids were more commonly associated with Black/African American individuals (OR=1.74, P<0.01) and less so with White races and Hispanic ethnicity. Significant comorbidities associated with increased risk included scarring alopecia, rosacea, atopic dermatitis, and acne. Inadequate sample size limited analysis for conditions like vitiligo. The findings suggest a higher prevalence of these scars in Black/African American races, potentially linked to melanocyte-mediated fibroblast and extracellular matrix activities. A notable correlation with inflammatory conditions suggests shared cytokine pathways, highlighting IL-4 and IL-13 as therapeutic targets. The strong association between scarring alopecia and skin cancers may implicate chronic inflammation and treatment-related scarring. Limitations of the study include its retrospective design, possible misdiagnosis, and small sample sizes for certain comorbidities. J Drugs Dermatol. 2025;24(2):212-215. doi:10.36849/JDD.8401R1.