A PUMCH team led by Professor Wang Xiaojun, based on clinical experience, researched into the pathology of keloid from basic medicine directions (genetics, cells and tissues). It searched for key targets, improved therapy plans and helped to promote across the country standardized, individualized therapies. The project won the third prize of 2018 Chinese Medical Sci-tech Award.
Keloid is a skin benign tumor commonly seen in Plastic Surgery. It usually invades surrounding normal tissues, with unbearable itching and tingling. It easily breaks and causes infections, and when it occurs repeatedly it might become scar cancer. It had long been a headache of plastic surgeons due to its unknown cause, difficult treatment and easy recurrence.
The team conducted basic research to find out the cause, and for the first time proved the existence of EMT in keloid tissues--in hypoxic microenvironment, HIF-1α expression increases, gives rise to EMT which, in turn, increases expression of HIF-1α. The team also compared the lncRNA of keloid and normal tissues, and found expression differences in several targets.
Keloid looks similar with hypertrophic scar (HS), but requires totally different treatment, therefore it is crucial to tell between them in a scientific, efficient way. The team was the first to use Laser Speckle Contrast Imaging (LSCI) on the diagnosis of keloid. It uses only three minutes and is accurate. LSCI can also be used on the recurrence of keloid.
For keloid of larger size, conventional therapy is skin grafting plus one-time radiotherapy, while a single dose is far from preventing recurrence. To reduce recurrence, the team, working closely with Radiotherapy, created the "pre-incision, pre-radiation" method. An incision is made before skin grafting to start healing, and radiation is made (within 48 hours after incision) to prevent over keloid healing and growing; radiation is made again after skin grafting, to reduce recurrence significantly. After radiation, the team creatively introduced hyperbaric oxygen therapy (HBOT) to block the hypoxic microenvironment for EMT, so as to effectively prevent inflammation and recurrence.
The team focused on this field for 15 years and boosted the 10-year curative ratio to 90%. Patients no longer had symptoms and their life quality was significantly improved. The team compiled PUMCH Keloid Guidelines, and, in recent three years, gave more than 50 lectures and trainings across the country, promoting its experience and helping local hospitals to break conventional boundaries. The team was supported by the National Natural Science Foundation and Beijing Natural Science Foundation, and has published a dozen SCI essays.
Keloid in chest, spreading in shapes of crab feet or centipede