Snapshot A 25-year-old African American woman presents to her dermatologist for a bothersome scar. She reports that a few months ago, she injured her arm after falling off a bike. Since then, her cut has healed and a raise flesh-colored scar has grown over the wound. It is often itchy or even painful. On physical exam, she has a 7 cm raised scar with irregular borders that extends beyond the original wound. (Keloid) Overview Skin is the largest organ of the body Functions login to view 5 more bullets Skin is made of the epidermis and dermis Anatomy Epidermis login to view 20 more bullets Dermis login to view 9 more bullets Normal Wound Healing Wound disrupts structure and function of epidermis Activates keratinocytes, fibroblasts, endothelial cells, platelets, and macrophages Hemostasis and inflammatory phase (0-3 days) login to view 5 more bullets Proliferative phase (3 days to weeks) login to view 11 more bullets Remodeling (weeks to months) login to view 6 more bullets Wound Closure Intentions Primary intention login to view 2 more bullets Secondary intention login to view 1 more bullet Tertiary intention (delayed closure) login to view 2 more bullets