Abstract
Cryosurgery is a common therapeutic modality used in dermatology; therefore we must be aware of its possible adverse effects. We report a case of a patient with subcutaneous emphysema which occurred following the application of cryotherapy after multiple punctures of local anesthetic and intralesional steroids in a chest keloid scar. Despite the fact that this condition was gradually resolved after expectant observation, we warn about this complication when sprayed cryotherapy is preceded by multiple punctures on cutaneous lesions above bony surfaces. In similar settings, cryotherapy must be first administered or a cotton-tip applicator should be used.
Highlights
Modern cutaneous cryosurgery was introduced in the 1960s [1], since it is commonly used by most dermatologists around the world
We report a patient with keloid scar who presented subcutaneous emphysema after cryotherapy application, an uncommon complication finding in dermatologic literature [4,5,6,7]
During sprayed cryotherapy an opening on the skin surface acts as a one-way valve through which the positive pressure gas enters and spreads along the subcutaneous compartment [1, 4, 6]
Summary
Modern cutaneous cryosurgery was introduced in the 1960s [1], since it is commonly used by most dermatologists around the world. It is recognized that this treatment was first applied in 1974 for keloidal scars by Pirece [2]. Cryotherapy induces vascular damage that leads to anoxia and tissue necrosis reducing the keloidal scar thickness [2, 3]. It is not an innocuous treatment and dermatologist must be aware of its side effects which can be immediate or delayed. We report a patient with keloid scar who presented subcutaneous emphysema after cryotherapy application, an uncommon complication finding in dermatologic literature [4,5,6,7]
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