Repair of Wide Coup de Sabre without Cutaneous Excision by Means of Pericranial-Galeal Padding Flap

Coup de sabre, a form of localized scleroderma, is a disease involving only the dermis with a normal epidermis. Multiple involvement in this entity is rare and considered by some authors as an extremely mild form of Rombergʼs hemiatrophy, in which there is only cutaneous involvement and the deeper structures are spared. The width of coup de sabre greatly influences its treatment. If the lesion is narrow, it can be resected and directly sutured; however, in the case of a wide lesion, several operative procedures, including resection, flap reconstruction, and expansion, have been described. We present an original approach for the treatment of wide localized scleroderma lesion following the diseaseʼs pathologic physiology and inspired from the treatment of Rombergʼs disease; without cutaneous resection, we performed reconstruction by filling tissues in the retracted area.