Is the Increase of Body Mass Index (BMI) A Risk Factor for Keloid?

Background: Although a number of hypotheses have been proposed for keloid pathogenesis, no single unifying hypothesis adequately explains its formation. For that reason, currently available therapies are palliative and have led to inconsistent results. The adipose tissue has been recognised as a reservoir of pro-inflammatory cytokines, which are directly involved in cell differentiation and proliferation, influencing fibrogenesis and wound healing. And, as the keloid is considered as a pro-inflammatory scar, increased adipose tissue could be a risk factor. Therefore, the objective of the present study was to evaluate the body mass index (BMI) of patients with keloids. Methods: Analytic, observational, cross-sectional, controlled study. Forty-three patients with keloid and 39 patients with normal scars were enrolled and had their BMI measured. All scars in both groups were at least one year old. Patients were selected from Plastic Surgery Outpatient Clinic. Results: BMI was higher in the keloid group than in the control group (p = 0.034). There was a higher prevalence of skin colour "white" patients (p = 0.003). Conclusion: Patients with keloid had higher BMI than those with normal scars. This result reinforces the hypothesis of the neuroimmunoendocrine nature of keloid in which the inflammatory pathway (with the production of proinflammatory mediators by the adipose tissue) plays a pivotal role, as in other skin diseases such as psoriasis.