{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:52:04Z","timestamp":1789786324230,"version":"4.0.1"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2003,11,27]],"date-time":"2003-11-27T00:00:00Z","timestamp":1069891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["pathsocjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Pathology"],"published-print":{"date-parts":[[2004,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The exact pathogenesis of hypertrophic scar and keloid formation is still unknown and a good therapy to prevent or treat these scars is lacking. Because immunological processes seem to be important in excessive scar formation, immunological cells and parameters were studied in a standardized breast reduction wound\u2010healing model in the present study. Standardized scar samples were taken from infra\u2010mammary breast reduction scars, 3 and 12 months following surgery. The samples were investigated for their number of mast cells, Langerhans cells, T\u2010lymphocytes, and macrophages, and the presence of interleukin\u20104 (IL\u20104) and counter\u2010regulating interferon\u2010gamma (\u03b3\u2010IFN), in relation to the scar's clinical appearance\u2014normal or hypertrophic. In this study, hypertrophic scar formation was significantly associated with an increased number of epidermal Langerhans cells (<jats:italic>p<\/jats:italic> = 0.0001) and significantly (<jats:italic>p<\/jats:italic> &lt; 0.05) increased expression of epidermal IL\u20104. No relationship was found between mast cell, T\u2010lymphocyte and macrophage numbers or \u03b3\u2010IFN staining and the formation of normal or hypertrophic scars. These results, combined with previous observation of abnormal keratinocyte behaviour in this context, indicate that the epidermal immune barrier plays an important role in the development of hypertrophic scars. Copyright \u00a9 2003 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/path.1502","type":"journal-article","created":{"date-parts":[[2003,12,19]],"date-time":"2003-12-19T03:03:33Z","timestamp":1071803013000},"page":"121-129","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":85,"title":["Hypertrophic scar formation is associated with an increased number of epidermal Langerhans cells"],"prefix":"10.1002","volume":"202","author":[{"given":"Frank B","family":"Niessen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joost","family":"Schalkwijk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Vos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim","family":"Timens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2003,11,27]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199910000-00031"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199108000-00012"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12343658"},{"key":"e_1_2_5_5_2","first-page":"185","article-title":"Immunologic associations of keloids","volume":"175","author":"Placik OJ","year":"1992","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004630-198703000-00008"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1054\/bjps.2001.3638"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0305-4179(97)00070-3"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1357-4310(97)80541-2"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5699(90)90176-A"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12668619"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/path.853"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/1523-1747.ep12696891"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI116015"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1038\/383787a0"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199811000-00023"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007611-197007000-00002"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-9896(1998100)186:2<192::AID-PATH163>3.0.CO;2-X"},{"key":"e_1_2_5_19_2","first-page":"105","article-title":"Morphological and immunochemical differences between keloid and hypertrophic scar","volume":"145","author":"Ehrlig HP","year":"1994","journal-title":"Am J Pathol"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00403728"},{"key":"e_1_2_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(80)90026-3"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/00004630-199709000-00007"},{"key":"e_1_2_5_23_2","first-page":"155","article-title":"Elevation of serum IgE in Japanese\u2010American children","volume":"41","author":"Mansfield LE","year":"1978","journal-title":"Ann Allergy"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.1987.01660260061013"},{"key":"e_1_2_5_25_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.4.989"},{"key":"e_1_2_5_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4362.1991.tb05871.x"},{"key":"e_1_2_5_27_2","first-page":"327","article-title":"The mast cell in hypertrophic scars","volume":"30","author":"Kischer CW","year":"1972","journal-title":"Tex Rep Biol Med"},{"key":"e_1_2_5_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0733-8635(18)30221-3"},{"key":"e_1_2_5_29_2","first-page":"427","article-title":"Mast cells in human keloid, small intestine, and lung by an immunoperoxidase technique using a murine monoclonal antibody against tryptase","volume":"124","author":"Craig SS","year":"1986","journal-title":"Am J Pathol"},{"key":"e_1_2_5_30_2","doi-asserted-by":"publisher","DOI":"10.1159\/000246625"},{"key":"e_1_2_5_31_2","first-page":"509","article-title":"Histamine and collagen synthesis in keloid and hypertrophic scar","volume":"23","author":"Cohen IK","year":"1972","journal-title":"Surg Forum"},{"key":"e_1_2_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0923-1811(96)00577-4"},{"key":"e_1_2_5_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF02285158"},{"key":"e_1_2_5_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.82.6.691"},{"key":"e_1_2_5_35_2","first-page":"53","article-title":"Comparative study of Langerhans cells in normal and pathological human scars. 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