{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T04:37:26Z","timestamp":1779338246532,"version":"3.51.4"},"reference-count":45,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,9,6]],"date-time":"2014-09-06T00:00:00Z","timestamp":1409961600000},"content-version":"vor","delay-in-days":5,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2014,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background and Aims<\/jats:title><jats:p>Hypertrophic scar is a form of abnormal wound healing process in which tissue repair regulating mechanism is disrupted. Transforming growth factor <jats:italic>\u03b2<\/jats:italic>1 has a particular importance in the fibrotic scarring response. Treatment of hypertrophic scar included many chemical, physical, and surgical options. Fractional <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>2 laser devices have gained acceptance as a way for managing hypertrophic scar. Aims of this study are: (a) to determine the clinical and histopathological effects of fractional <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>2 laser on hypertrophic scar, (b) to evaluate the expression pattern of transforming growth factor\u2010<jats:italic>\u03b2<\/jats:italic>1 (<jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\u2010<jats:italic>\u03b2<\/jats:italic>1) as an important fibrogenic factor before and 6\u00a0months after fractional <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>2 laser treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Forty patients of hypertrophic scar were selected, each patient was treated by four sessions with 1\u00a0month apart with fractional <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>2 laser. Vancouver Scar Scale (<jats:styled-content style=\"fixed-case\">VSS<\/jats:styled-content>) was used to assess the patients before and after laser treatment. Skin biopsy was taken from eight cases before and 3\u00a0months after four fractional <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>2 laser sessions and four normal skin control biopsies. All were assessed by hematoxylin\u2010eosin (H&amp;E), Masson's trichrome, Van Gieson and immunohistochemical (<jats:styled-content style=\"fixed-case\">IHC<\/jats:styled-content>) staining with <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\u2010<jats:italic>\u03b2<\/jats:italic>1. The epidermal thickness was assessed before and after treatment by image analyzing system software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was statistically significant difference in <jats:styled-content style=\"fixed-case\">VSS<\/jats:styled-content> before and after fractional <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>2 laser (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.001). The epidermal thickness showed significant increase after laser treatment (<jats:italic>P<\/jats:italic>\u00a0&gt;\u00a00.001), and there was also thinning in stratum corneum and replacement of the irregular collagen bands with organized new collagen fibrils as demonstrated by H&amp;E and the other special stains. The study also showed significant decrease in <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\u2010<jats:italic>\u03b2<\/jats:italic>1 expression after laser therapy (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Fractional <jats:styled-content style=\"fixed-case\">CO<\/jats:styled-content>2 laser could be considered as a good way for hypertrophic scar management. It normalizes dermal collagen as imaged by histopathological picture and the change in <jats:styled-content style=\"fixed-case\">TGF<\/jats:styled-content>\u2010<jats:italic>\u03b2<\/jats:italic>1 expression.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.12099","type":"journal-article","created":{"date-parts":[[2014,9,6]],"date-time":"2014-09-06T08:30:46Z","timestamp":1409992246000},"page":"169-179","source":"Crossref","is-referenced-by-count":67,"title":["Evaluation of the effect of fractional <scp>CO<\/scp>2 laser on histopathological picture and <scp>TGF<\/scp>\u2010<i>\u03b2<\/i>1 expression in hypertrophic scar"],"prefix":"10.1111","volume":"13","author":[{"given":"Mohamed","family":"Makboul","sequence":"first","affiliation":[{"name":"Faculty of Medicine Plastic Surgery Department Assiut University Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rania","family":"Makboul","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Pathology Department Assiut University Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Assem HK","family":"Abdelhafez","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Plastic Surgery Department Assiut University Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Safaa Said","family":"Hassan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Histology Department Assiut University Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherif M","family":"Youssif","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Plastic Surgery Department Assiut University Assiut Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,9,6]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fsc.2011.06.006"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sap.0000155276.93061.93"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1473-2165.2008.00360.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.matbio.2013.02.004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.3109\/08830189809043009"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0022-202X.2005.23771.x"},{"key":"e_1_2_6_8_1","first-page":"874","article-title":"Morphological and morphometric study of cultured fibroblast from treated and untreated abnormal scar","volume":"30","author":"Ali SS","year":"2010","journal-title":"Saudi Med J"},{"key":"e_1_2_6_9_1","first-page":"18","article-title":"The role of the TGF\u2010\u03b2 family in wound healing, burns and scarring: a review","volume":"2","author":"Penn JW","year":"2012","journal-title":"Int J Burns Trauma"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.LAB.0000027841.50269.61"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-475X.2007.00261.x"},{"key":"e_1_2_6_12_1","first-page":"774","article-title":"Low risk of postinflammatory hyperpigmentation in skin types 4 and 5 after treatment with fractional CO2 laser device","volume":"7","author":"Tan KL","year":"2008","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.07.054"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2009.03215.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2009.08.006"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004630-200021030-00005"},{"key":"e_1_2_6_17_1","first-page":"4","article-title":"Development, validation and testing of a human tissue engineered hypertrophic scar model","volume":"29","author":"Broek LJ","year":"2012","journal-title":"Altex"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1529-8019.2009.01265.x"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/14764172.2013.780448"},{"key":"e_1_2_6_20_1","volume-title":"Dermatologic Surgical Procedures. 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