Author(s)
Zain Mehdi, BA
Aaron Mackie, BS
Heli Majeethia, BS
Daniel Gorelik, MD
Tariq Syed, MS
Anthony E. Brissett, MD
Affiliation(s)
Houston Methodist Hospital (Mehdi, Gorelik, Syed, Brissett) and Texas A&M College of Medicine (Mackie);
Abstract:
Background: Keloid scarring affects 5-15% of patients within the U.S. and associated with physical, mental, and emotional morbidity. Research on keloids remains limited and may contribute to health disparities.
Objectives: We seek to evaluate disease-specific funding and research output for keloids compared to hidradenitis suppurativa (HS) given similarities in demographics, current understanding, and management and compared to rosacea given differences in racial predominance.
Design Type: cross-sectional study
Methods: This study examined disease-specific US-based interventional trial volumes on ClinicalTrials.gov, total federal funding reported on the NIH RePORTER database, and total publications in PubMed. Funding was stratified by estimated U.S. prevalence (10% for keloids, 1% for HS, 9.6% for rosacea)
Results: Between 2008 and 2024, total disease specific NIH funding was similar between keloids, HS, and rosacea: $28.9 million, $25.8 million, and $28.1 million. Keloid and rosacea funding per patient were lower than HS: $0.84 vs $0.82 vs $7.00. Keloids had the fewest clinical trials compared to HS and rosacea: 50 vs 109 vs 126. Keloid research productivity totaled 4143 publications (158 trials, 24 observational studies, and 51 meta-analyses). HS productivity totaled 4739 (96 trials, 88 observational studies, 60 meta-analyses). Rosacea productivity totaled 3185 publications (189 trials, 35 observational studies, 36 meta-analyses).
Conclusion: Keloids are underfunded and understudied in the U.S. when compared to other cutaneous diseases of similar morbidity or differing racial predominance, especially after factoring in disease prevalence.