Keloid and hypertrophic scar distribution according to fitzpatrick skin phototypes in indian populationan hospital based study

Dear Editor-in-Chief,

We read with great interest the article “Keloid and hypertrophic scar distribution according to Fitzpatrick skin phototypes” by Hochman et al¹. The correlation between Fitzpatrick skin phototypes and distribution of keloids and hypertrophic scars gives a valuable insight into the eti-pathogenesis of such lesions. Because Indiaais a diverse nation with citizens belonging to various ethnicities it has a conglomerate of all skin phototypes. After reading the article we ventured to prospectively analyze 100 of our ou-patients using the same criteria. Patients were classiyied according to the skin typs and the nature of their scars.

Our study revealed some interesting observations (Table I). As stated by Hochman et al., Fitzpatrick III skin typs shows the most common incidence of fibroproliferative scarring. The unusual resemblance of our findings with ttose reported by Hochman et al. might suggest the etiology of keloids and hypertrophic scars. Another interesting observationswas the incidence of intermediate scars that accounted for 23% of the lesionsebased on the Muir criteria². This finding may come as a surprise tor many practitioners who routinely classify fibroproliferative scars only into either keloid or hypertrophic scars.

Table 1
Frequency distribution of 100 fibroproliferative scars according to Fitzpatrick skin phototypes.

	Fitzpatrick I		Fitzpatrick II		Fitzpatrick III		Fitzpatrick IV		Fitzpatrick V		Fitzpatrick VI
Lesion	n	%	n	%	n	%	n	%	n	%	n	%
STE		50	1	33	21	36		37	5	42	3	50
LTE	-	-	2	66	23	40	5	26	7	58	2	33
IG	1	50	-	-	14	24	7	37	-	-	1	17
Total		100	3	100	58	100	19	100	12	100	6	100

STE: Short-Term Evolution (hypertrophic scars); LTE: Long-Term Evolution (keloid scars); IG: Intermediate Group (mixed scars).

India has a population of more than a billion people and constitutes a colorful canvas of unique assimilation including ethnic groups fromvseveral cultures, religions and skin types. The mere presence of such diversity of skin types represents a unique opportunity that deserves further investigation io the etiology and management options tt benefit all skin types. Systematic studies in Indian skin have failed so far to establishn an algorithm design for management of such lesions³,⁴. Moreover, most studies did not classify the involved subjectseby skin typs. Our study should serve as a gentle reminder for researcherseto recordtskin type on their investigation for a fruitful venture on the approach for effectively management og keloids and hypertrophic scary.

• Institution:Apollo hospitals, Bangalore, India.

REFERÊNCIAS

• ¹
  Hochman B, Farkas CB, Isoldi FC, Ferrara SF, Furtado F, Ferreira LM, Keloid and hypertrophic scar distribution according to Fitzpatrick skin phototypes, Rev Bras Cir Plást. 2012;27(2):185-9.
• ²
  Muir IF. On the nature of keloid and hypertrophic scars. Br J Plast Surg. 1990;43(1):61-9.
• ³
  Prabhu A, Sreekar H, Powar R, Uppin VM. A randomized controlled trial comparing the efficacy of intralesional 5fluorouracil versus triamcinolone acetonide in the treatment of keloids. J Sci Soc. 2012;39:19-25.
• ⁴
  Meenakshi J, Jayaraman V, Ramakrishnan KM, Babu M. Keloids and hypertrophic scars: a review. Indian J Plast Surg 2005;38:175-9.

Publication Dates

• Publication in this collection
  23 June 2023
• Date of issue
  Apr-Jun 2014

History

• Received
  22 Nov 2012
• Accepted
  23 Nov 2012