Bony Hyperplasia Beneath Atrophic Soft Tissue: A Rare Case of En Coup de Sabre and Literature Review

Abstract

In this study, we report a rare case of en coup de sabre with hyperplasia of the left frontal bone beneath skin lesion, which is detected during magnetic resonance imaging screening and preoperative evaluation. A 27-year-old woman with 13-year history of progressive soft tissue depression in the forehead and scalp, and was treated by traditional Chinese herb before the disease went into stationary stage. The patient underwent serial long-pulsed laser treatments and autologous fat grafting with satisfactory outcome. To our knowledge, this is the first time that bony hyperplasia beneath the soft tissue lesion was found in a patient with en coup de sabre.

Keywords:

• localized scleroderma
• morphea
• autologous fat grafting
• magnetic resonance imaging
• computed tomography

Abbreviations

ECDS, en coup de sabre; MRI, magnetic resonance imaging; CT, computed tomography; ANA, antinuclear antibody; ds-DNA, NA double-stranded antibody; LoSCAT, Localized Scleroderma Cutaneous Assessment Tool; PUMC LoSFAI, Peking Union Medical College LoS facial aesthetic index.

Consent Statements

This study has been approved by the Institutional Review Board of Peking Union Medical College Hospital; approval I-22PJ352. Written informed consent has been obtained from the patient for publication of her photograph and information.

Acknowledgments

The research reported in this article was supported by grants from National Key Research and Development Program of China (2020YFE0201600), Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Science (2020-I2M-C&T-A-004 and 2021-I2M-1-003) and National High Level Hospital Clinical Research Funding of China (2022-PUMCH-A-210, 2022-PUMCH-B-041 and 2022-PUMCH-C-025).

Disclosure

The authors report no conflicts of interest in this work.