瘢痕疙瘩的发病机制、临床特征及治疗进展综述

A Review on the Pathogenesis, Clinical Features, and Therapeutic Advances of Keloids

摘要: 瘢痕疙瘩(Keloids)是一种常见的皮肤纤维增生性疾病，表现为创伤后皮肤组织的过度修复反应，其发病机制复杂，涉及遗传易感性、慢性炎症、细胞外基质代谢紊乱及成纤维细胞异常活化等多种因素。近年来，随着分子生物学和免疫学研究的深入，瘢痕疙瘩的病理机制逐渐被揭示，但其确切病因仍不完全明确。临床上，瘢痕疙瘩表现为超出原始伤口边界的隆起性瘢痕，常伴有瘙痒、疼痛及功能障碍，严重影响患者的生活质量。目前，治疗方法包括手术切除、糖皮质激素注射、放射治疗、激光治疗及新型生物制剂等，但复发率高仍是临床面临的重大挑战。本文系统综述了瘢痕疙瘩的流行病学特征、分子机制、临床表现、诊断标准及最新治疗进展，旨在为临床实践和未来研究提供理论依据和方向。

Abstract: Keloids are a common fibroproliferative skin disorder characterized by an exaggerated wound-healing response following cutaneous injury. The pathogenesis of keloids is complex and involves multiple factors, including genetic predisposition, chronic inflammation, dysregulation of extracellular matrix metabolism, and aberrant activation of fibroblasts. In recent years, advances in molecular biology and immunology have gradually elucidated the underlying pathological mechanisms; however, the precise etiology remains incompletely understood. Clinically, keloids present as raised scars that extend beyond the boundaries of the original wound and are frequently accompanied by pruritus, pain, and functional impairment, significantly compromising patients’ quality of life. Current therapeutic modalities include surgical excision, intralesional corticosteroid injections, radiotherapy, laser therapy, and emerging biologic agents; nevertheless, high recurrence rates continue to pose a major clinical challenge. This review systematically summarizes the epidemiological features, molecular mechanisms, clinical manifestations, diagnostic criteria, and recent advances in the management of keloids, aiming to provide a theoretical foundation and future directions for clinical practice and research.