Keloid Scarring, but Not Dupuytren\u27s Contracture, Is Associated with Unexplained Carotid Atherosclerosis

Abstract

BACKGROUND: Atherosclerosis, a response to injury, may be thought of as scarring in the artery wall. TGF-beta and associated signaling molecules have been implicated in the pathophysiology of keloid scarring, Dupuytren\u27s Contracture and atherosclerotic plaques in independent studies. PURPOSE: To test the hypothesis that excess cutaneous scarring and Dupuytren\u27s contractures predispose independently to carotid atherosclerosis . METHODS: Among 1,747 patients with plaque measurements and complete data for multivariable regression analysis, 57 Caucasian patients had Dupuytren\u27s contractures and 12 had keloid scars. Carotid total plaque area (TPA) was measured by 2-Dimensional ultrasound. RESULTS: In linear multivariable regression analysis with coronary risk factors, keloid scars were associated with TPA (P= 0.018), but Dupuytren\u27s contractures were not. Patients with keloid scarring were younger (P \u3c 0.0001), and more likely to be diabetic (P \u3c 0.0001) CONCLUSIONS: Keloid scarring is a clinical clue to excess atherosclerosis not explained by traditional risk factors. Such patients may benefit from therapy directed at targets related to signalling molecules common to both the process of keloid scarring and atherosclerosis. These findings suggest previously unexplored possibilities for the prevention and treatment of atherosclerosis. The differences between Dupuytren\u27s and keloid scars that may identify such targets are discussed

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