Scars Ehlers-Danlos syndrome

H. G. Gaig, E. W. Lippay, and P. J. Neame, Proteoglycans in human bum hypertrophic scars from a patient with Ehlers-Danlos Syndrome. Carbohydr. Res., in press. 

Apart from a few exceptional cases (e.g. Ehlers-Danlos syndrome), the destruction of the papillary dermis does not cause hypertrophic scarring. 

Ehlers-Danlos syndrome, keloid scars, if the peel is to the papillary dermis... 

The prognosis is much better if the scar results from overpeeling (technical error) rather than the nature of the skin itself (e.g. with Ehlers-Danlos syndrome). A technical error can be put down to experience, and there is no reason why it should happen again during a repeat peel. If the scarring results from the patient s genetic make-up, she or he should not be given another peel. 

Several collagen disorders result from defects in the formation of cross-links (Chapter 11). The cross-linking disorders can be due to a hereditary deficiency of lysyl oxidase, inhibition of lysyl oxidase, deficiency of copper, defects in the formation of cross-links, or defects in their stabilization. The genetic deficiency of lysyl oxidase is characterized by Ehlers-Danlos syndrome type IX (Table 25-5) and some forms of cutis laxa. Type IX Ehlers-Danlos syndrome patients exhibit extreme extensibility of the skin, cigarette-paper scarring, and easy bruisability. In cutis laxa, the skin is loose and inelastic and appears to be too large for the surface it covers. Some affected individuals exhibit deficiency of lysyl oxidase, presumably... 

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