Characterization of Dyschromic Hypertrophic Scar

Study Overview
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Brief Summary
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Currently, there are limited prevention or treatments available for dyschromia in burn hypertrophic scars (HTSs). The limited available techniques involve transferring melanocytes from unaffected areas to the scar to adjust pigment. These techniques involve the creation of a donor site and do not utilize the cells that may already be present in scars. This study aims to confirm melanocyte presence in regions of hypo- and hyper- pigmented HTS. If melanocytes can be found in regions of hypopigmentation, these scars may be able to be treated in the future by pigmentation stimulators without the need for surgery. Additionally, if pigmentation specific molecules of interest can be found to be up-regulated in hyperpigmented scar, these may be able to be altered by a pharmacotherapy.

Detailed Description
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Subjects with burn scars that are lighter and/or darker than their normal skin will be asked to participate in this study. It is being done to obtain more information about why some people develop scars that are different in color to their normal skin after trauma to the skin such as a burn. Participants who wish to participate will have scar measured with a ruler, and study sites identified and photographed. Additionally the following procedures will be done: Non-invasive measurements: Each area of scar will have multiple non-invasive measurements done. These include: scar scales - subjective measures of color, itching, pain, height, etc. elasticity - a probe is briefly placed on top of the skin to measure its ability to stretch induration - a probe is briefly placed on top of the skin to measure how firm it is color - a skin probe in briefly placed on top of the skin to measure its color Biopsies: Based on the measurement of the scars, several small 3mm punch biopsies will be done. Subjects with light colored scars and total scar greater than 500cm2 are eligible to participate in an optional sub-study. For this sub-study, an additional excisional biopsy 1 cm by 2 cm in the shape of an oval will be obtained from the lighter colored scar. Blood collection: Blood will be collected for correlating blood characteristics to scar outcome. Approximately 20 mL of blood will be collected, which is less than 2 tablespoons. A portion of this blood might be used in the future for genome sequencing of pigmentation or hypertrophic scar-related gene sequences. Whole genome sequencing will not be performed. Interview: Personal information, medical history, health behaviors, and scar history will be reviewed. Data collection: Information about initial burn injury, hospitalization, and outpatient visits will be requested from the medical record.

Official Title
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Characterization of Dyschromic Hypertrophic Scar: An Observational Clinical Trial

Conditions
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Burn Scar, Hypertrophic Scar, Hyperpigmentation, Hypopigmented Scar

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years of age or older Skin trauma resulting in a dyschromic scar Exclusion Criteria: Dyschromic scar dole to face, genitals, fingers, or toes Known Lidocaine allergy Pregnancy Prisoner Status

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identify Melanocyte Presence | Confirm melanocyte presence in regions of hyper- and hypo-pigmented HTS, as well as normal skin by multiple assays including en face staining and immunofluorescent staining with melanocytes markers. | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Characterize Pigmentation Signaling | Compare pigmentation signaling molecules between hyper-, hypo-, and normally pigmented scar and skin using immunofluorescent staining and gene expression analysis. | 1 year | 
| Characterize melanin levels using non-invasive skin probes | Obtain average melanin index, fibrosis, and elastimeter values for subjects with dyschromic hypertrophic scar. | 1 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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burn, scar, hypertrophic scar, dyspigmentation, dyschromic scar