Sir,
A 25-year-old male admitted to us with acute diarrheal disorder had his initials embedded on the left forearm [Figure 1]. It looked unusual since it appeared that the initials were made of fibrous tissue. Initially, we thought it to be made by a heated alphabetical iron cast. But questioning revealed otherwise. He narrated the history as:
Figure 1.
Hypertrophic scar in the shape of english alphabets
“I wished to have my initials over the left forearm in a way that it can be never removed. Since, the age of 12 years I made repetitive cuts in the shape of my initials over my forearm with a shaving razor blade. Once it began to heal I will repeat the cuts over the newly formed scar. The cuts were repeated at least for 10 occasions. After 5 years, I had these initials which will probably live with me for ever!”
The initials were a alphabetical hypertrophic scar. The white fibrous tissue was not extending beyond the margins of the scar. He had no pain over the scar. Clinical psychiatry evaluation showed no evidence of significant psychological illness.
Deliberate self-harm is common among adolescents.[1] Self-harm is often nonfatal and carries with it a wide spectrum of reasons. This case where the self-harm was of artistic intention is interesting.
REFERENCE
- 1.Hawton K, Rodham K, Evans E, Weatherall R. Deliberate self harm in adolescents: Self report survey in schools in England. BMJ. 2002;325:1207–11. doi: 10.1136/bmj.325.7374.1207. [DOI] [PMC free article] [PubMed] [Google Scholar]