{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T14:36:52Z","timestamp":1773326212622,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T00:00:00Z","timestamp":1493769600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2017,12]]},"abstract":"Abstract<\/jats:title>Keloids grow and do not regress. They are characterised histologically by hyalinised keloidal collagen (HKC<\/jats:styled-content>). HKC<\/jats:styled-content> amounts vary, and the mechanism by which they form is unclear. To clarify how HKCs<\/jats:styled-content> form and whether their formation associates with specific clinical features, we studied the histological findings of earlobe keloids and compared them with respective clinical features. A total of 50 earlobe keloids from 43 patients were used for histological analysis of keloid size (mm2<\/jats:sup>), HKC<\/jats:styled-content> area (mm2<\/jats:sup>) and HKC<\/jats:styled-content> area ratio (%). As a result, keloid durations ranged from 3 months to >13 years. Early\u2010stage keloids exhibited little HKC<\/jats:styled-content> and a tendency for the HKCs<\/jats:styled-content> to locate in perivascular regions. In later\u2010stage keloids, the HKCs<\/jats:styled-content> were extremely interconnected and formed a thick bitten donut\u2010shaped region. HKC<\/jats:styled-content> area ratios correlated positively with keloid duration (r<\/jats:italic>2<\/jats:sup> = 0\u00b758, P<\/jats:italic><0\u00b705). HKC<\/jats:styled-content> area ratios and keloid durations did not correlate with keloid sizes. These patterns of HKC<\/jats:styled-content> formation and growth may explain why local therapies, which effectively remove fibroblasts and accumulated collagen but not HKCs<\/jats:styled-content>, are ineffective in older keloids. Keloids should be promptly treated after diagnosis, and older keloids with extensive HKCs<\/jats:styled-content> may require surgical excision followed by radiotherapy.<\/jats:p>","DOI":"10.1111\/iwj.12763","type":"journal-article","created":{"date-parts":[[2017,5,3]],"date-time":"2017-05-03T10:26:44Z","timestamp":1493807204000},"page":"1088-1093","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Histological analysis of hyalinised keloidal collagen formation in earlobe keloids over time: collagen hyalinisation starts in the perivascular area"],"prefix":"10.1111","volume":"14","author":[{"given":"Noriko M","family":"Matsumoto","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei\u2010Xia","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Integrated Diagnostic Pathology, Graduate School of Medicine Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayo","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Akaishi","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryuji","family":"Ohashi","sequence":"additional","affiliation":[{"name":"Department of Pathology Nippon Medical School Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rei","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School Tokyo 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