Upsurging cases of en coup de sabre: Distinctive clinical manifestations in a series of 41 patients | [Journal of Pakistan Association of Dermatologists • 2024]

Author(s):

1. Khalifa E. Sharquie: Department of Dermatology, College of Medicine, University of Baghdad/ Medical City Teaching Hospital,,Iraq

2. Raed I. Jabbar: Department of Dermatology, Fallujah Teaching Hospital,Al-Anbar Health Directorate, Anbar,Iraq

3. Inas K. Sharquie: Department of Microbiology and Immunology, College of Medicine, University of Baghdad,Baghdad,Iraq

Abstract:

Background En coupe de sabre is not uncommon connective tissue disorder of children and adult and often end with marked deep scarring that starts very early and ending with scarring of the skin and scarring alopecia of scalp. Objective The aim of current study is to screen for patients with en coup de sabre among cases with morphea and to evaluate the different clinical and histopathological features of the disease. Methods This is cross sectional descriptive clinical study where all patients with morphea were screened for en coup de sabre and their clinical manifestations including scarring alopecia. Full clinical history and examination were carried for all patients that were seen during the period from 2014-2023 years. Biopsies for histopathological evaluation were carried out. Results A total number of 181 patients with different types of morphea were seen. En coup de sabre was detected in 41 (22.65%) cases with female to male ratio was 2.72:1. The age onset of the disease was ranged from 4-28 years. Five (12.19%) were observed cases with face only but no scalp involvement and scarring alopecia was detected in 36(87.8%) of patients. One of the distinctive early features of the en coup de sabre of the face was the presence of rectangular mostly hyperpigmented and sometimes hypopigmented bands. Histopathological assessment showed mild acanthosis with normal dermal-epidermal junction but with pigmented basal layer while the dermis revealed mild inflammatory reaction with collagen deposition in early lesions while complete skin sclerosis was noticed in late lesions. Conclusion En coup de sabre is a disease of children and young ages and mostly seen among females. There are early and late distinctive clinical and histopathological pictures. It is common cause of scarring of the face and scalp. Early detection of these patients is mandatory to prevent permanent complications.

Page(s): 85-91

DOI: DOI not available

Published: Journal: Journal of Pakistan Association of Dermatologists, Volume: 34, Issue: 1, Year: 2024

Keywords:

localized scleroderma , Morphea , eolgtEn coupe de sabre

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