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JAMA Dermatology Clinicopathological Challenge
September 2013

Scar Reactivation in a Postpartum Woman

Author Affiliations
  • 1Mayo Clinic, Rochester, Minnesota
JAMA Dermatol. 2013;149(9):1097-1098. doi:10.1001/jamadermatol.2013.181

A 33-year-old woman was referred by her primary health care provider for increasing prominence of facial scars. The scars were sustained during a bicycle accident at age 5 years and were minimally appreciable until 10 weeks after the delivery of her third child. At that time, the patient noted the sudden development of linear pink, thin plaques within the scar sites. The lesions developed a deeper red to reddish yellow color over the next 2 months, and she was referred to the dermatology department (Figure 1). Dermoscopy revealed an “apple jelly” appearance to the lesions. Previous treatments included topical corticosteroids, with minimal improvement. Her medical and obstetric history, which included 2 prior pregnancies, was unremarkable. Two 3-mm punch biopsy specimens were obtained from the lesions for hematoxylin-eosin staining.