Sock-line scarring on the calf of a six-week-old boy
This was a case that presented at the Department of Dermatology and Allergy Centre, Odense University Hospital and the Department of Paediatrics, Lillebaelt Hospital Kolding, Kolding, Denmark (2013).
A 6-week-old boy was sent to the Department of Paediatrics with what appeared to be linear eruptions on his left calf. He was healthy when he was born at term with a birth weight of 4,300 g. The day before admission his parents had noted a red streak on his leg. A new mark with small blisters was noticed on the day of admission (Fig. 1A). The paediatrician concluded that the skin lesions on the left leg had an artificial appearance. Physical examination revealed no other abnormal findings. The boy appeared to have age-appropriate growth and development. Routine blood tests and skin culture were normal.
The doctors were confused to say the least. They weren't sure what this was and they were beginning to suspect child abuse.
The patient was then referred to the Department of Dermatology for further evaluation. Skin examination by the dermatologists revealed 2 demarcated hyperpigmented red horizontal bands on the left calf. The lesions were slightly elevated. The dermatologists had seen this before. They quickly made a diagnosis of sock-line scarring. His parents were informed that the skin lesions were due to injuries from elastic bands in tight socks. The pigmentation and scarring was still visible on the infant more than one year after onset.
Sock-line scarring is acquired, linear circumferential or partially circumferential hyperpigmentations on the calf or ankle, representing a post-traumatic phenomenon associated with tight socks. Tight elastic bands of socks or pant legs may cause dermal inflammation or panniculitis, which may heal with post-inflammatory changes resembling sock lines. When patients have been biopsied the histology showed post-inflammatory hyperpigmentation or lentiginous melanocytic hyperplasia or basal layer hyperpigmentation.
Sock-line bands run a benign course and typically resolve within a few months, although persistence after 2–5 years of follow-up or even until adulthood has been reported.
More awareness of this condition can easily prevent it from happening to babies. So, please help us share this information.
Our cute baby socks have an elastic that is not too tight or too loose. This means that they won't scar your baby's legs. This also means that they are super easy to put on and they stay on, without hurting or scarring your baby.
For more resources to learn about sock-line scarring, please read:
1. Berk DR, Bayliss SJ. Infantile garment bands. J Pediatr 2012; 161: 965.e1.
2. Berk DR, Tapia B, Lind A, Bayliss SJ. Sock-line hyperpigmentation: case series and literature review. Arch Dermatol 2007; 143: 428–430.
3. Marque MM, Guillot B, Le Gallic G, Bessis D. Raised limb bands in infancy: a post-traumatic aetiology? Br J Dermatol 2007; 156: 578–579.
4. Berk DR, Bayliss SJ. Sock-line bands: presentation of additional follow-up and eight new cases. Pediatr Dermatol 2011; 28: 83–84.
5. Berk DR, Bayliss SJ. Mitten-line hyperpigmentation: a reactive process analogous to sock-line hyperpigmentation. Pediatr Dermatol 2010; 27: 401–402.
6. Zhu YI, Fitzpatrick JE, Weston WL. Congenital curvilinear palpable hyperpigmentation. J Am Acad Dermatol 2005; 53: S162–164.