Three-Dimensional Analysis of Intraepidermal Nerve Fibres and Langerhans Cells in Keloids with a Focus on Pruritus

This study examined the relationship between pruritus in keloids and nerve fibres, focusing on anterior chest and ear keloids. Using three-dimensional immunofluorescence, researchers found numerous nerve fibres infiltrating the epidermis in the periphery of anterior chest keloids, where pruritus was reported, and observed substance P gene expression, a pruritus mediator, in these areas. No differences in Langerhans cells were noted. The findings suggest that intractable pruritus in anterior keloid lesions is associated with increased intraepidermal nerve fibre density and elevated expression of Th2 cytokines and substance P.