{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T18:27:29Z","timestamp":1789064849945,"version":"build-2803163510"},"reference-count":94,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,7]],"date-time":"2024-04-07T00:00:00Z","timestamp":1712448000000},"content-version":"vor","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Keloid are a fibroproliferative disorder caused by abnormal healing of skin, specifically reticular dermis, when subjected to pathological or inflammatory scars demonstrating redness, elevation above the skin surface, extension beyond the original wound margins and resulting in an unappealing cosmetic appearance. The severity of keloids and risk of developing keloids scars are subjected to elevation by other contributing factors such as systemic diseases, general health conditions, genetic disorders, lifestyle and natural environment. In particular, recently, daily physical work interpreted into mechanical force as well as the interplay between mechanical factors such as stress, strain and stiffness have been reported to strongly modulate the cellular behaviour of keloid formation, affect their location and shape in keloids. Herein, we review the extensive literature on the effects of these factors on keloids and the contributing predisposing mechanisms. Early understanding of these participating factors and their effects in developing keloids may raise the patient awareness in preventing keloids incidence and controlling its severity. Moreover, further studies into their association with keloids as well as considering strategies to control such factors may help clinicians to prevent keloids and widen the therapeutic options.<\/jats:p>","DOI":"10.1111\/iwj.14865","type":"journal-article","created":{"date-parts":[[2024,4,8]],"date-time":"2024-04-08T00:19:55Z","timestamp":1712535595000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["The effects of systemic diseases, genetic disorders and lifestyle on keloids"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-3284-9115","authenticated-orcid":false,"given":"Guangpeng","family":"Xia","sequence":"first","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7316-8961","authenticated-orcid":false,"given":"Teruyuki","family":"Dohi","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Abdelhakim","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamiko","family":"Tosa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-555X","authenticated-orcid":false,"given":"Rei","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,4,7]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14243"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mehy.2016.09.024"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.matbio.2015.08.001"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18030606"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0b013e31829c4597"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010199910000\u201000031"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3182a97f9e"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12277"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/HCO.0000000000000742"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003173"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/exd.14154"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266\u2010022\u201003229\u20103"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20103\u2010030\u201044766\u20103_4"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.15576"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/wrr.12197"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.5999\/aps.2013.40.1.70"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534\u2010197510000\u201000019"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000077"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1530\/REP\u201021\u20100428"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1468\u20103083.2003.00614_11.x"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.12154"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu15020352"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1631\/jzus.B2200036"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555\u2010019\u201000327\u20100"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/1535370217700524"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581\u2010020\u20100278\u20105"},{"key":"e_1_2_6_28_1","first-page":"1","article-title":"Does keloid\/hypertrophic scar develop in diabetic patient?: analysis of 292 patients","volume":"11","author":"Watanabe M","year":"2017","journal-title":"Scar Manage"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dsx.2015.04.007"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12325\u2010014\u20100140\u2010x"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23126820"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000006904"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/5281358"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.2337\/db13\u20100927"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10103\u2010017\u20102154\u20105"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.2147\/CCID.S267192"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1086\/322585"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1089\/wound.2015.0642"},{"key":"e_1_2_6_39_1","unstructured":"The Tuberculosis Surveillance Center.Tuberculosis in Japan: annual report. 2021. Accessed February 26 2022.https:\/\/jata.or.jp\/english\/dl\/pdf\/TB_in_Japan_2021.pdf.Date"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555\u2010023\u201000916\u20100"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2015.02.056"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555\u2010016\u20100105\u2010x"},{"key":"e_1_2_6_43_1","doi-asserted-by":"publisher","DOI":"10.7812\/TPP\/20.225"},{"key":"e_1_2_6_44_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annder.2017.01.019"},{"key":"e_1_2_6_45_1","doi-asserted-by":"publisher","DOI":"10.18240\/ijo.2018.08.01"},{"key":"e_1_2_6_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2019.12.002"},{"key":"e_1_2_6_47_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.01810"},{"key":"e_1_2_6_48_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201088789\u20101"},{"key":"e_1_2_6_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/burnst\/tkac025"},{"key":"e_1_2_6_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2017.09.010"},{"key":"e_1_2_6_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20103\u20100348\u20100837\u20108_17"},{"key":"e_1_2_6_52_1","doi-asserted-by":"publisher","DOI":"10.1159\/000454919"},{"key":"e_1_2_6_53_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.603187"},{"key":"e_1_2_6_54_1","doi-asserted-by":"publisher","DOI":"10.4103\/aam.aam_56_18"},{"key":"e_1_2_6_55_1","doi-asserted-by":"publisher","DOI":"10.7150\/ijbs.23230"},{"key":"e_1_2_6_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346\u20108138.16638"},{"key":"e_1_2_6_57_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001336"},{"key":"e_1_2_6_58_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.15569"},{"key":"e_1_2_6_59_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2018.00939"},{"key":"e_1_2_6_60_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajd.13224"},{"key":"e_1_2_6_61_1","doi-asserted-by":"publisher","DOI":"10.1080\/19381980.2018.1448327"},{"key":"e_1_2_6_62_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2022.104868"},{"key":"e_1_2_6_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.14374"},{"key":"e_1_2_6_64_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocd.15636"},{"key":"e_1_2_6_65_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-44766-3_8"},{"key":"e_1_2_6_66_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.13124"},{"key":"e_1_2_6_67_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41431\u2010022\u201001097\u20108"},{"key":"e_1_2_6_68_1","doi-asserted-by":"publisher","DOI":"10.1186\/1750\u20101172\u20102\u201032"},{"key":"e_1_2_6_69_1","doi-asserted-by":"publisher","DOI":"10.1111\/1523\u20101747.ep12286441"},{"key":"e_1_2_6_70_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2006.11.008"},{"key":"e_1_2_6_71_1","doi-asserted-by":"publisher","DOI":"10.1002\/humu.23139"},{"key":"e_1_2_6_72_1","doi-asserted-by":"publisher","DOI":"10.3928\/0191\u20103913\u201020050901\u201016"},{"key":"e_1_2_6_73_1","doi-asserted-by":"publisher","DOI":"10.1159\/000491924"},{"key":"e_1_2_6_74_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.a.37567"},{"key":"e_1_2_6_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524\u2010475X.2012.00766.x"},{"key":"e_1_2_6_76_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00403\u2010012\u20101278\u20105"},{"key":"e_1_2_6_77_1","doi-asserted-by":"publisher","DOI":"10.1093\/burnst\/tkac036"},{"issue":"6","key":"e_1_2_6_78_1","first-page":"15","article-title":"Distensibility and gross elasticity of the skin at various body sites and association with pathological scarring: a case study","volume":"11","author":"Sano H","year":"2018","journal-title":"J Clin Aesthet Dermatol"},{"key":"e_1_2_6_79_1","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0b013e31819967ed"},{"key":"e_1_2_6_80_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000005717"},{"key":"e_1_2_6_81_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001357"},{"key":"e_1_2_6_82_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/1490492"},{"key":"e_1_2_6_83_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004084"},{"key":"e_1_2_6_84_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40200\u2010015\u20100182\u2010x"},{"key":"e_1_2_6_85_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep18899"},{"key":"e_1_2_6_86_1","doi-asserted-by":"publisher","DOI":"10.7150\/thno.50905"},{"key":"e_1_2_6_87_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0007114515002093"},{"key":"e_1_2_6_88_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/2476493"},{"key":"e_1_2_6_89_1","doi-asserted-by":"publisher","DOI":"10.3390\/biom12121783"},{"key":"e_1_2_6_90_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00238\u2010011\u20100661\u20103"},{"key":"e_1_2_6_91_1","doi-asserted-by":"publisher","DOI":"10.1038\/srep42642"},{"key":"e_1_2_6_92_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22479"},{"key":"e_1_2_6_93_1","doi-asserted-by":"publisher","DOI":"10.1042\/CS20160236"},{"key":"e_1_2_6_94_1","doi-asserted-by":"publisher","DOI":"10.3109\/02844318909075119"},{"key":"e_1_2_6_95_1","doi-asserted-by":"publisher","DOI":"10.1177\/2059513119868659"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.14865","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T06:33:02Z","timestamp":1754289182000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.14865"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":94,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1111\/iwj.14865"],"URL":"https:\/\/doi.org\/10.1111\/iwj.14865","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]},"assertion":[{"value":"2023-08-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-03-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-04-07","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e14865"}}