Repir of coup de sabre, a linear form of scleroderma. Case report

Survival of grafts in coup de sabre

BACKGROUND

Treatment of coup de sabre must remain conservative until the disease is no longer in an active state. When activity has ceased, some operative intervention is safe and effective for the correction of deformity. While hair transplantation showed high survival rates for the correction of cicatricial alopecia, it has not yet been reported to be performed for the correction of coup de sabre.

OBJECTIVE

To examine the therapeutic possibility of hair transplantation for the correction of coup de sabre.

METHODS

Follicular units consisting of two to three hairs from the patient's occipital scalp were transplanted using Choi hair transplanters.

RESULTS

Ten-month follow-up studies showed an 86.5% survival rate and 10-14 cm (mean 12 cm) length of the transplanted hairs.

CONCLUSION

When coup de sabre is no longer in an active state, hair transplantation is a useful method for cosmetic improvement of the alopecia.

Repair of wide coup de sabre without cutaneous excision by means of pericranial-galeal padding flap

A case of double linear scleroderma of the forehead (coup de sabre) is described. The histopathology of this rare lesion is now well known with a normal epidermis and a sclerotic dermis. The correction was done with an original two-stage procedure: the lesion with alopecia was first treated by excision-suture and a transfer of the involved subcutaneous tissue along the right inner canthus; 1 year later, by a hemicoronal incision, we transferred a galeal-pericranial flap beneath the wider forehead lesion. We think that the use of a filling flap to correct wide coup de sabre lesions without cutaneous excision can be a simple alternative to the classic treatment by complete excision and flap reconstruction. The subcutaneous fascial system of the scalp can provide a good donor site with minimal morbidity.

Repair of "coup de sabre" with tissue expander

Two cases of coup de sabre, a linear form of scleroderma, treated by means of tissue expansion, are discussed. Expanded skin flaps on the scalp and forehead provided sufficient skin and tissue for closure of the defect after resection of the defect, and good results were obtained.

Progressive hemifacial atrophy

Twenty-three cases of progressive hemifacial atrophy with their modalities of treatment have been reviewed. The importance of and need for proper planning and a coordinated approach are stressed. Generally, the final result has been highly satisfactory to the patient.