Keloid on scapular area secondary to therapeutic dry cupping

Dear Editors,

Cupping glass therapy is rarely discussed in modern medical literature. It was commonly used for producing negative pressure in the field of oriental (Chinese) medicine. Cupping dates back over 3000 years, and is still believed to relieve pain and is used by alternative medicine practitioners, although evidence from well‐designed randomised trials is lacking.

Two representative forms of cupping therapy are popular. One is dry cupping. Cups are placed on the candidate's skin area to be treated and suction is applied using negative pressure. The other is wet cupping, which involves minimal incisions at the acupuncture points followed by placement of cups over the incisions, with small volume of bleeding.

Keloids are a proliferative ailment of fibrous tissue secondary to trauma, infection, surgery and other various causes 1. Although cupping therapy is popular in an Asian population to relieve pain and other symptoms, no keloid cases have been reported in the literature. As trauma is one of the major causes, keloids can develop when wet cupping therapy is performed.

We report a recent case of a patient who suffered from keloids on her scapular area caused by dry cupping therapy performed by an oriental medicine practitioner (Figure 1). The patient complained of intermittent itchiness and pain. She refused corticosteroid injection therapy because of the pain due to injection. Keloid in the scapular area can result in severe aesthetic problems, posing a significant burden on the patient 2, 3.

Figure 1.

A keloid scar on the right scapular area of the patient.

Apart from its extreme rarity, we report this case to remind the clinician that both wet and dry cupping therapy by regulated oriental practitioners can result in unexpected keloids. Therefore, we stress the importance of exercising caution during cupping therapy and providing sufficient preexplanation to the patient regarding the possibility of keloid formations.

Tae Hwan Park1,2
1Deokjeok Health Care Center, Incheon, Republic of Korea
2Department of Plastic Surgery, Keloid Research
Foundation, New York, NY, USA
hard-piano@hanmail.net