Cones of skin occur where hypertrophic scar occurs

Hypertrophic scarring is devastating for the patient, however the pathophys iology and treatment remain unknown after decades of research, The process follows deep dermal Injury, occurs only on certain body parts, does not occ ur in the early fetus or in animals, and is a localized event. This suggest s that an anatomic structure in human, deep dermis may be involved, The der mis is a matrix perforated by cones containing many structures including sk in appendages and fat domes, We hypothesized that studying the cones might reveal a structure related to scarring. We examined tangential wounds from various body parts on human cadavers along with skin histology from various human body parts, the early fetus, partial thickness burns, hypertrophic s cars, and two other species-rats and rabbits, We found that the cones may i n fact be the structure, They exist where hypertrophic scar occurs-cheek, n eck, chest, abdomen, back, buttock, arm, forearm, dorsal hand, thigh, leg, dorsal foot, helix and ear lobe, They do not exist where hypertrophic scar does not occur-scalp, forehead, concha, eyelid, palm, early fetus, and in r at, or rabbit, It also became apparent that the cones have been omitted fro m most considerations of skin histology. We suggest that the cones need to be studied in relation to hypertrophic scarring and restored to skin diagra ms.