Silver-stained nucleolar organizer regions in hypertrophic and keloid scars

Silver-stained nucleolar organizer regions (AgNORs) have been widely used as a marker of cellular activity and proliferation. In a retrospective study, we investigated the potential value of AgNORs in 12 hypertrophic and 24 keloid scar tissues. Ten normal skin tissues served as controls. A standard silver-straining method was used, and the mean AgNOR count of dermal fibroblastic cells in each tissue was determined. In normal skin, the mean AgNOR count of dermal fibroblasts was 1.79 +/- 0.55, whereas fibroblastic cells in hypertrophic and keloid scars had mean AgNOR counts of 3.18 +/- 0.56 and 5.10 +/- 0.97, respectively. There was a statistically significant difference between the mean AgNOR counts of fibroblastic cells from normal skin, hypertrophic scar, and keloid scar [one-factor analysis of variance (ANOVA), p < 0.0001]. Our findings suggest that AgNOR count may be a useful marker for assessment of fibroblastic cell activity in hypertrophic and keloid scars, which may have potential value for histologic and biologic characterization of the two lesions.