Immunohistochemical evaluation of the cleft-affected scar tissue three decades post-corrective surgery: A rare case report

Cleft lip and palate are the most common congenital malformations which require early primary cleft surgery in all infants. The surgical treatment of cleft lip and palate deformities results in the formation of scar tissue. However, the scarred tissue has sparsely been immunohistochemically evaluated to date. Herein, we report the differences in the cellular expression of various proteins in the scar and nearby healthy tissue of a 35-year-old patient who underwent cleft correction surgery during infancy. The scar tissue showed basal cell proliferation, prominent cysts, and fibrotic connective tissue. An increased expression of both interleukin 1 alpha (IL-1 alpha) and IL-10 in the scar tissue was noted, although the balance favored an anti-inflammatory environment. No differences in the expression of matrix metallopeptidase-2 (MMP-2) and TIMP-2 were found whilst an increased expression of PAX-9 and MSX-1 was observed in the scar tissue, which co-localized with RYK expression. Temporal studies like the present one can aid in advancing our understanding of the longitudinal processes governing wound healing morpho-pathogenesis in cleft-affected patients.