Atrophic scar

Fig. 9.15. A 56-year-old patient with wrinkles and atrophic scar due to old cutaneous leishmaniasis before (a) and 3 -months after (b) deep chemical peel...

West TB (1997) Laser resurfacing of atrophic scars. Dermatol Clin 15 449-457... 

Atrophic scars (icepick, rolling, boxcar) Hypertrophic scars (keloids)... 

Discoid lupus erythematosus discoid patches with adherent thick scales and follicular plugging, atrophic scarring... 

A 75-year-old man with prostatic carcinoma took flutamide for 18 months and developed blisters on the back of the hands and fingers after exposure to the sun (4). The bullae were associated with skin fragility and atrophic scarring. Histopathology and direct immunofluorescence showed ultrastructural features similar to those described in porphyria cutanea tarda. However, porphyrin concentrations in the urine and blood were normal. Flutamide was withdrawn and the lesions healed, without relapse after 11 months. 

A 58-year-old nurse who was given parenteral pentazocine developed large sclerotic and infected areas with multiple depressed atrophic scars at sites of prior ulceration unsterile injection technique could not be excluded as a cause (11). 

Lesions on sun-exposed skin, particularly the backs of the hands, forearm, and face, are present in all patients. These lesions are identical to those seen in the other bullous porphyrias (Table 32-4). Increased mechanical fragility of the skin, with trivial trauma leading to erosions, is present in virtually aU patients. Subepidermal bullae, hypertrichosis of the face, and patchy pigmentation are also common. Erosions and bullae heal slowly to leave atrophic scars, milia, and depigmented areas. Patchy or diffuse sclerodermatous changes are less common and, unlike the other skin lesions, may affect areas of the trunk that are not exposed to sun. 

Atrophic scars resulting from a face-lift... 

Atrophic scar after a face-lift, resulting from a local secondary infection. 

Fixed erythema, flat or raised, over the malar eminences, tending to spare the nasolabial folds Erythematous raised patches with adherent keratotic scaling and follicular plugging atrophic scarring may occur in older lesions... 

AstraZeneca AB, Sodertalje, Sweden), can be applied prior to treatment. After facial washing with soap, the skin is cleansed with alcohol. Either 65% or 100% TCA is focally applied on the entire depressed area of atrophic scars or enlarged facial pores with pressure using various applicators (Figures 10.7-10.10). The skin is monitored carefully until it reaches a frosted appearance after a single application of TCA, which usually occurs within 10 seconds. The frosted appearance is the result of coagulation of epidermal and dermal proteins and is used mainly to monitor the peel depth. After the procedure, the treated areas are cooled down with ice packs to reduce excessive inflammation and pain. 

Figure 15.11 Hypopigmentation and atrophic scarring occurred in this 34-year-old woman who vigorously scrubbed a brown spot using an over the counter glycolic acid preparation...

In the era before antiviral medication, I observed four cases which developed mild atrophic scarring after herpes simplex complications. Two herpetic infections followed medium peels and two occurred following phenolic peels... 

Proionged unsightiiness 10. Atrophic scarring 15. Darkening of nevi... 

Prolonged unsightliness 11. Atrophic scarring 17. Line of demarcation... 

Swelling 2. Transient erythema 10. Telangiectasia 11. Atrophic scarring 19. Exacerbation of concurrent disease... 

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