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The microenvironment of PSs is shaped by a diverse array of cells, collectively forming a profibrotic and proangiogenic niche. Recent advances in high-throughput sequencing have enhanced our understanding of the cellular heterogeneity, transcriptional changes, and intercellular communication within the PS microenvironment. This review comprehensively describes the cellular landscape of PSs, including mesenchymal cells, endothelial cells, epithelial cells, and immune cells. Additionally, we evaluate precision medicine strategies ranging from biomarker-driven diagnostics to targeted biological therapies and innovative drug delivery systems. We aim to provide a mechanistic framework that accelerates the translation of basic experimental research into effective and personalized treatments for pathological scarring.<\/jats:p>","DOI":"10.1093\/burnst\/tkag050","type":"journal-article","created":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T12:04:15Z","timestamp":1785585855000},"source":"Crossref","is-referenced-by-count":0,"title":["Deciphering the cellular landscape of pathological scars"],"prefix":"10.1093","volume":"14","author":[{"given":"Yixin","family":"Sun","sequence":"first","affiliation":[{"name":"Center for Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People\u2019s Hospital (Affiliated People\u2019s Hospital), Hangzhou Medical College , No. 158, Shangtang Road, Gongshu District, Hangzhou, Zhejiang 310014,","place":["China"]},{"name":"Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking 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Medical Sciences and Peking Union Medical College , No. 41, Damucang Hutong, Xicheng District, Beijing 100032,","place":["China"]},{"name":"Center for Regenerative Medicine and Plastic Surgery Research, Peking Union Medical College Hospital , No. 41, Damucang Hutong, Xicheng District, Beijing 100032 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina","family":"Tao","sequence":"additional","affiliation":[{"name":"School of Clinical Medicine, University of Cambridge , Cambridge Biomedical Campus, Hills Road, Cambridge CB2 0SP,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyu","family":"Li","sequence":"additional","affiliation":[{"name":"Center for Plastic and Reconstructive Surgery, Department of Plastic and Reconstructive Surgery, Zhejiang Provincial People\u2019s Hospital (Affiliated People\u2019s Hospital), Hangzhou Medical College , No. 158, Shangtang Road, Gongshu District, Hangzhou, Zhejiang 310014,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiuzuo","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 41, Damucang Hutong, Xicheng District, Beijing 100032,","place":["China"]},{"name":"Center for Regenerative Medicine and Plastic Surgery Research, Peking Union Medical College Hospital , No. 41, Damucang Hutong, Xicheng District, Beijing 100032 ,","place":["China"]},{"name":"Beijing Key Laboratory of Aging Regulation and Translational Intervention for Skin and Soft Tissue , No. 41, Damucang Hutong, Xicheng District, Beijing 100032 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-3675-7199","authenticated-orcid":false,"given":"Nanze","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 41, Damucang Hutong, Xicheng District, Beijing 100032,","place":["China"]},{"name":"Center for Regenerative Medicine and Plastic Surgery Research, Peking Union Medical College Hospital , No. 41, Damucang Hutong, Xicheng District, Beijing 100032 ,","place":["China"]},{"name":"Beijing Key Laboratory of Aging Regulation and Translational Intervention for Skin and Soft Tissue , No. 41, Damucang Hutong, Xicheng District, Beijing 100032 ,","place":["China"]},{"name":"Department of International Medical Service, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College , No. 41, Damucang Hutong, Xicheng District, Beijing 100032 ,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Sun","sequence":"additional","affiliation":[{"name":"Center for Plastic and Reconstructive 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