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Keloid scars arising in striae caused by bra straps
The role of surgery in the management of congenital melanocytic naevi in children 43. Kishi K, Matsuda N, Kubota Y, et al. Rapid, severe repigmentation of congenital melanocytic naevi after curettage and dermabrasion: histological features. Br J Dermatol 2007;156:1251e7. 44. West EA, McPartland JL, Rigby H, et al. Giant bathing trunk naevus with lymphadenopathy and unusual pathology. Br J Dermatol 2007;157:599e601. 45. Za ¨tterstro ¨m U, Thor A, Nordgren H. Cervical metastasis from Spitz nevus of the buccal mucosa. Melanoma Res 2008;18:36e9. 46. Hori Y, Nakayama J, Okamoto M, et al. Giant congenital nevus and malignant melanoma. J Invest Dermatol 1989;92:310Se4S. 47. Kadonaga J, Barkovich AJ, Edwards MSB, et al. Neurocutaneous melanosis in association with the Dandy-Walker complex. Pediatr Dermatol 1992;9:37e43.
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48. Kinsler VA, Aylett SE, Coley SC, et al. Central nervous system imaging and congenital melanocytic naevi. Arch Dis Child 2001; 84:152e5. 49. Wieselthaler NA, van Toorn R, Wilmshurst JM. Giant congenital melanocytic nevi in a patient with brain structural malformations and multiple lipomatosis. J Child Neurol 2002;17:289e91. 50. Takano T, Morimoto M, Sakaue Y, et al. Large congenital melanocytic nevi presenting with lissencephaly with an absent corpus callosum. Congenit Anom (Kyoto) 2008;48:97e100. 51. Ruiz-Maldonado R, del Rosario Barona-Mazuera M, HidalgoGalva ´n LR, et al. Giant congenital melanocytic nevi, neurocutaneous melanosis and neurological alterations. Dermatology 1997;195:125e8.
CLINICAL OBSERVATION Keloid scars arising in striae caused by bra straps A 22-year-old woman presented with a 4-year history of abnormal scars on both shoulders and no prior acne or trauma. A previous piercing of her left helical rim had left a bulky post-auricular scar which had been excised without recurrence, and she had no other abnormal scars. The scars were consistent with keloids and lay under the bra strap exclusively within striae the patient attributed to the pull of the bra (Figure 1A and B). Her bra size was 34J, her body mass index (BMI) was 33 and she had no striae elsewhere. Treatment with silicone ointment and weight loss was commenced. Keloid scarring has been previously described in striae of the abdomen but not of the shoulder.1 This case confirms that keloids can arise and suggests that striae at any site may carry a risk of keloids. The trigger for their development remains unknown.
Conflicts of interest statement None.
Funding source The authors undertook this case study during the course of their NHS clinical work and received no additional funding.
Ethical approval Formal ethical approval was not sought for this case study. The patient was treated as normal. Full consent was obtained for clinical photograph publication.
Reference 1. Hashimoto K. Linear focal elastosis: keloidal repair of striae distensae. J Am Acad Dermatol 1998;39:309e13.
Alastair G. Lowrie Omar A. Ahmed Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK E-mail address: [email protected]
Figure 1 (A) The scars were consistent with keloids. (B) The scars lay under the bra strap exclusively within the striae, attributed to the pull of the bra.
ª 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2009.01.016
601
48. Kinsler VA, Aylett SE, Coley SC, et al. Central nervous system imaging and congenital melanocytic naevi. Arch Dis Child 2001; 84:152e5. 49. Wieselthaler NA, van Toorn R, Wilmshurst JM. Giant congenital melanocytic nevi in a patient with brain structural malformations and multiple lipomatosis. J Child Neurol 2002;17:289e91. 50. Takano T, Morimoto M, Sakaue Y, et al. Large congenital melanocytic nevi presenting with lissencephaly with an absent corpus callosum. Congenit Anom (Kyoto) 2008;48:97e100. 51. Ruiz-Maldonado R, del Rosario Barona-Mazuera M, HidalgoGalva ´n LR, et al. Giant congenital melanocytic nevi, neurocutaneous melanosis and neurological alterations. Dermatology 1997;195:125e8.
CLINICAL OBSERVATION Keloid scars arising in striae caused by bra straps A 22-year-old woman presented with a 4-year history of abnormal scars on both shoulders and no prior acne or trauma. A previous piercing of her left helical rim had left a bulky post-auricular scar which had been excised without recurrence, and she had no other abnormal scars. The scars were consistent with keloids and lay under the bra strap exclusively within striae the patient attributed to the pull of the bra (Figure 1A and B). Her bra size was 34J, her body mass index (BMI) was 33 and she had no striae elsewhere. Treatment with silicone ointment and weight loss was commenced. Keloid scarring has been previously described in striae of the abdomen but not of the shoulder.1 This case confirms that keloids can arise and suggests that striae at any site may carry a risk of keloids. The trigger for their development remains unknown.
Conflicts of interest statement None.
Funding source The authors undertook this case study during the course of their NHS clinical work and received no additional funding.
Ethical approval Formal ethical approval was not sought for this case study. The patient was treated as normal. Full consent was obtained for clinical photograph publication.
Reference 1. Hashimoto K. Linear focal elastosis: keloidal repair of striae distensae. J Am Acad Dermatol 1998;39:309e13.
Alastair G. Lowrie Omar A. Ahmed Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, NE1 4LP, UK E-mail address: [email protected]
Figure 1 (A) The scars were consistent with keloids. (B) The scars lay under the bra strap exclusively within the striae, attributed to the pull of the bra.
ª 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.bjps.2009.01.016