RESUMEN
RATIONALE: Ear keloid is one of the more common forms of keloid, which may cause pain and itching, and is aesthetically unappealing. Recurrence is common with any monotherapy which prompted a comprehensive, multidimensional approach. PATIENT CONCERNS: A 24-year-old female was evaluated in our department on April 6, 2021, due to an "8-year recurrence following a left ear keloid resection." In July 2013, a left auricle keloid excision was performed in a local hospital. One year following the operation, the scar at the surgical site had proliferated, gradually spreading beyond the original scar borders. Patients worry about recurrence after surgery affecting the appearance of the ear. DIAGNOSIS: Ear keloid. INTERVENTIONS: The patient underwent a 2-stage re-resection of the keloid, followed by postoperative radiotherapy, and triamcinolone acetonide injection around the incision at the time of the second operation. Finally, silicone gel was applied for antiscar treatment. OUTCOMES: There has been no postoperative recurrence of ear keloid during the 12-month follow-up. LESSONS: For ear keloids, combination therapy offers an improved approach with an excellent aesthetic appearance and less risk of recurrence than traditional monotherapy.
Asunto(s)
Pabellón Auricular , Queloide , Femenino , Humanos , Adulto Joven , Adulto , Queloide/etiología , Queloide/cirugía , Terapia Combinada , Triamcinolona , Pabellón Auricular/cirugía , Inyecciones Intralesiones , Resultado del Tratamiento , RecurrenciaRESUMEN
OBJECTIVE: To induce hair follicle regeneration in rat ear by microencapsulated dermal papillae (DP) cells. METHODS: Intact dermal papillae were obtained from human scalp follicles which were digested with collagenase I. The human hair DP cells were encapsulated with alginate-polylysine-alginate (APA) by a high-voltage electric field droplet generator. The diameters of the DP cell microcapsules were optimized by regulating the voltage, the distance between the needle head and the solution surface and the injection speed. Then DP cell microencapsulations were xenotransplanted into ears of 20 SD rats with a novel method. One rat was killed every week at the postoperative 2-12 weeks and the implantation sites were biopsied for histological observation. RESULTS: The DP cell microencapsulations were found in a group of round, smooth and transparent microcapsules under a phase-contrast microscope. The optimal combination of parameters to obtain 0.4 mm DP cell microcapsules was voltage 7.0 kV, injection speed 55 mm/h, and distance 10 mm. After 4-12 weeks, 18 of 20 DP cell microcapsule implantations had produced high-density hair. Histological observation indicated that both large follicles and sebaceous gland structures were formed in the rat ear within 3-12 weeks. CONCLUSIONS: These findings show that the DP cell microencapsulation maintain the capacity for initiating the follicle regeneration and can be considered as a substitute for fresh isolated dermal papillae.
Asunto(s)
Dermis/citología , Folículo Piloso/fisiología , Animales , Dermis/fisiología , Oído , Femenino , Humanos , Masculino , Modelos Animales , Ratas , Ratas Sprague-Dawley , Regeneración/fisiologíaRESUMEN
Dermal papillae (DP) play a pivotal role in hair formation, growth and cycling. However, the number of DP is limited. In this study, we report the production of "reconstructed DP" by enclosing DP cells within an alginate-polylysine-alginate (APA) semipermeable membrane. MTT assay and electron microscopy showed that the microencapsulated dermal papilla cells retained normal activity. The microcapsules were implanted into rat footpads, which lack follicles and sebaceous glands, to assess their inductive properties. Histologic examination showed that numbers of follicle and sebaceous gland structures formed in the footpads within 6-10-week period. At the 10 weeks following transplantation, hair fibers were visible in the footpad. These findings indicate that the DP cell microcapsules retain the capacity to initiate follicle regeneration and could be considered a substitute for fresh isolated DPs.
Asunto(s)
Dermis/citología , Cámaras de Difusión de Cultivos/métodos , Composición de Medicamentos/métodos , Células Epiteliales/citología , Animales , Dermis/fisiología , Células Epiteliales/fisiología , Femenino , Folículo Piloso/citología , Folículo Piloso/fisiología , Humanos , Masculino , Ratas , Ratas Sprague-Dawley , Regeneración/fisiologíaRESUMEN
OBJECTIVE: To induce the hair follicle regeneration in mice ear by microencapsulated dermal papillae cells (DPs) and to investigate the permeability of fluorescein in APA microencapsulation to search the ideal diameter of microencapsulation. METHODS: The DPs were encapsulated with alginate-polylysine-alginate by a high-voltage electric field droplet generator. The microencapsulated dermal papilla cells were xenotransplanted into the mice ears. After 6 week, the histological examination was made by microscopy. The diffusion way and speed of fluorescein into the microencapsulations were observed by confocal laser scanning microscopy. The comparison of fluorescein intensity was made in APA microencapsulations with different diameters. RESULTS: Fully developed hair follicles could be easily identified in the skin of implanted site following xenotransplantation of microencapsulation DPs, which were different from the control groups in configuration, number, size and differentiation degree. The fluorescein was diffused gradually into the microencapsulations with a shape of concentric circularity. The fluorescein intensity inside three groups of APA microencapsulations was: small > middle > big. CONCLUSIONS: The microencapsulated DPs retain the physiological function to induce the follicle regeneration. The APA microencapsulations with 400um diameter could ensure the nutrition and metabolite to pass in and out freely, and isolate the immunocompetent substance absolutely.