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Aicardi–Goutières syndrome 6 (AGS6) is a serious auto-immunization-associated acute neurologic decompensation. AGS6 manifests as acute onset of severe generalized dystonia of limbs and developmental regression secondary to febrile illness mostly. Dyschromatosis symmetrica hereditaria (DSH), as pigmentary genodermatosis, is a characterized mixture of hyperpigmented and hypopigmented macules. Both AGS6 and DSH are associated with ADAR1 pathogenic variants. To explore the etiology of a proband with developmental regression with mixture of hyperpigmentation and hypopigmentation macules, we used the trio-WES. Later, to clarify the association between variants and diseases, we used guidelines of ACMG for variants interpretation and quantitative Real-time PCR for verifying elevated expression levels of interferon-stimulated genes, separately. By WES, we detected 2 variants in ADAR1 and a variant in TSC2, respectively, were NM_001111.5:c.1096_1097del, NM_001111.5:c.518A>G, and NM_000548.5:c.1864C>T. Variants interpretation suggested that these 3 variants were both pathogenic. Expression levels of interferon-stimulated genes also elevated as expected. We verified the co-occurrence of pathogenic variants of ADAR1 and TSC2 in AGS6 patients with DSH. Our works contributed to the elucidation of ADAR1 pathogenic mechanism, given the specific pathogenic mechanism of ADAR1, and it is necessary to consider with caution when variants were found in ADAR1. [ABSTRACT FROM AUTHOR]

The study objective was to determine whether the discounts provided under the 340B program help address disparities in drug treatment and adverse outcomes among Medicare Fee-For-Service (FFS) beneficiaries initially Medicare-diagnosed with moderate to severe chronic asthma. Using Medicare FFS claims data from 2017 to 2019, we conducted a cross-sectional study that compared risk-adjusted differences in 5 treatment measures and 5 adverse outcomes among beneficiaries treated within 340B and non-340B hospital systems that met the disproportionate share (DSH) criteria and the ownership classification requirement to qualify as a 340B DSH hospital. Our analysis focused on potential disparities that are historically associated with challenges to accessing quality health care. We did not observe fewer disparities in drug treatments or adverse outcomes for beneficiaries with moderate to severe asthma treated at 340B hospital systems compared to non-340B hospital systems. These results raise questions as to whether 340B hospital systems are effectively using discounts to focus on improved access and outcomes for vulnerable beneficiaries. [ABSTRACT FROM AUTHOR]

As early as the end of the 1990 s, the advantages and disadvantages of the DSH examination as well as the possibility of its further development were already being discussed. The question of centralised or decentralised design played a major role in the debate. This article discusses terms that are central for the DSH: linguistic study skills, study relevance, and academic orientation.Furthermore, the article shows how the quality assurance of all university entrance examinations, introduced in the RO-DT of 2011, shapes today's design of the DSH. This article also reveals which role FaDaF plays in this process, supporting German universities in implementing uniform quality standards. Criteria catalogues for the creation and assessment of examinations play a special role. In addition, the article deals with the sample DSH and the DSH manual that are based on it. In the final section, the innovations of the DSH examination regulations are also highlighted.The article thus sheds light on how the DSH, as a decentralized examination designed by universities for universities, is trying to meet the challenges of the 21st century in the field of activity between universities, HRK, FaDaF and the DSH office. [ABSTRACT FROM AUTHOR]

Dyschromatosis symmetrica hereditaria (DSH), characterized by a mixture of hyper- and hypopigmented macules on the skin, is a rare pigmentary dermatosis of autosomal dominant inheritance. The pathogenic gene is adenosine deaminase acting on the RNA 1 gene (ADAR1), mutations in this gene also lead to Aicardi-Goutières syndrome type 6 (AGS 6), a rare hereditary encephalopathy with isolated spastic paraplegia. The pathomechanism of the ADAR1 gene mutations inducing DSH has not been clarified yet. We report the first case of DSH combined with AGS caused by the homozygous mutation of the ADAR1 gene in China (c.1622T > A) and reviewed the relevant literature. AGS 6 could occur in both men and women, and start in infancy. The main characteristics are growth retardation, skin depigmentation, intracranial calcification, and cerebral white matter lesions. In the current paper, the proband also had patent ductus arteriosus (PDA), ventricular septal defect (VSD), and mitral valve calcification, which are new symptoms that have not been reported in other cases. Additionally, we also aim to discuss the possible molecular mechanisms underlying the clinical heterogeneity caused by ADAR1 gene mutations.

Background: Self-harm is a serious public health problem across the world, impacting not only people who self-harm but also their families and society as a whole through higher resource costs and productivity losses. This review was conducted among the general Saudi population to investigate the prevalence of non-suicidal self-injury (NSSI) and factors affecting it. Methods: An electronic literature search of four major databases, PubMed, Web of Science, Scopus Science Direct, and Google Scholar, was conducted to include eligible studies. All studies reporting NSSI or relevant to the subject were included. Results: A total of five articles with 1758 participants were included. The lowest recorded NSSI prevalence was 0.47% while the highest was 10.2%, both in Al-Khobar city. Conclusion: We recorded a relatively low but increasing prevalence of NSSI. The review also demonstrated that NSSI was more common among the female population and young people. Self-poisoning, including drug overdose, was the most prevalent method of self-harm. Interpersonal difficulties, marital problems, academic failure, and family and self-conflicts were common motivating factors of NSSI.

Background: Although there is a growing body of literature on the epidemiology of deliberate self-harm (DSH) in South Africa, comparatively few studies have investigated the motives for self-harm. No studies have investigated the motives for DSH in Cape Town. Aim: The objective of the study was to identify the range of motives for DSH in Cape Town, and how these motives are associated with different socio-demographic factors, the severity of self-injury and levels of suicidal intent. Setting: Groote Schuur Hospital in Cape Town, South Africa. Methods: Data were collected from 238 consecutive patients presenting with DSH to the emergency department. The data were analysed by using bivariate and multivariate analyses. Results: Patients engaged in DSH for a range of motives. Interpersonal issues were the most common motive (70%), followed by financial concerns (22%). Male patients were twice as likely as female patients to report interpersonal motives for their self-harm. Patients who reported interpersonal issues were more likely to engage in methods of DSH that involved damage to body tissues. Patients without tertiary education were more likely to report academic concerns as a motive, and patients who reported psychiatric illness as motive for DSH were more likely to require medical interventions than those who did not. Conclusion: This study contributes novel insights into the motives for DSH in the Cape Town context and provides the foundation for continued research on the subject. The study also gives impetus to the development of therapeutic interventions focussed on the motives for self-harm.

Background: Although there is a growing body of literature on the epidemiology of deliberate self-harm (DSH) in South Africa, comparatively few studies have investigated the motives for self-harm. No studies have investigated the motives for DSH in Cape Town. Aim: The objective of the study was to identify the range of motives for DSH in Cape Town, and how these motives are associated with different socio-demographic factors, the severity of self-injury and levels of suicidal intent. Setting: Groote Schuur Hospital in Cape Town, South Africa. Methods: Data were collected from 238 consecutive patients presenting with DSH to the emergency department. The data were analysed by using bivariate and multivariate analyses. Results: Patients engaged in DSH for a range of motives. Interpersonal issues were the most common motive (70%), followed by financial concerns (22%). Male patients were twice as likely as female patients to report interpersonal motives for their self-harm. Patients who reported interpersonal issues were more likely to engage in methods of DSH that involved damage to body tissues. Patients without tertiary education were more likely to report academic concerns as a motive, and patients who reported psychiatric illness as motive for DSH were more likely to require medical interventions than those who did not. Conclusion: This study contributes novel insights into the motives for DSH in the Cape Town context and provides the foundation for continued research on the subject. The study also gives impetus to the development of therapeutic interventions focussed on the motives for self-harm. [ABSTRACT FROM AUTHOR]

Abstract Dyschromatosis symmetrica hereditaria (DSH) and reticulate acropigmentation of Kitamura (RAK) are rare, inherited pigmentary diseases. DSH shows a mixture of pigmented and depigmented macules on the extremities. RAK shows reticulated, slightly depressed pigmented macules on the extremities. The causative gene of DSH was clarified as ADAR1 by positional cloning including linkage analysis and haplotype analysis in 2003. Ten years later, the causative gene of RAK was identified as ADAM10 by whole-exome sequencing, in 2013. ADAR1 is an RNA-editing enzyme which catalyzes the deamination of adenosine to inosine (A-to-I) in double-stranded RNA substrates during post-transcription processing. Inosine acts as guanine during translation, resulting in codon alterations or alternative splice sites that lead to functional changes in proteins when they occur in coding regions. In 2012, it was clarified that ADAR1 mutations cause Aicardi-Goutières syndrome 6, which is a severe genetic inflammatory disease that affects the brain and the skin. A zinc metalloprotease, a disintegrin and metalloprotease domain-containing protein 10 (ADAM10), is involved in the ectodomain shedding of various membrane proteins and shows various functions in vivo. ADAM10 is known to be involved in the ectodomain shedding of Notch proteins as substrates in the skin. We speculate that the pathogenesis of RAK and Dowling-Degos disease (DDD, a pigmentary disease similar to RAK) is associated with the Notch signaling pathway. In addition, ADAM10 mutations proved to be associated with late-onset Alzheimer disease. This review comprehensively discusses the updated pathophysiology of those genetic pigmentary disorders. [ABSTRACT FROM AUTHOR]

Growing axons are exposed to various guidance cues en route to their targets, but the mechanisms that govern the response of growth cones to combinations of signals remain largely elusive. Here, we found that the sole Robo receptor, SAX-3, in Caenorhabditis elegans functions as a coreceptor for Wnt/CWN-2 molecules. SAX- 3 binds to Wnt/CWN-2 and facilitates the membrane recruitment of CWN-2. SAX-3 forms a complex with the Ror/CAM-1 receptor and its downstream effector Dsh/DSH-1, promoting signal transduction from Wnt to Dsh. sax-3 functions in Wnt-responsive cells and the SAX-3 receptor is restricted to the side of the cell from which the neurite is extended. DSH-1 has a similar asymmetric distribution, which is disrupted by sax-3 mutation. Taking these results together, we propose that Robo receptor can function as a Wnt coreceptor to regulate Wnt-mediated biological processes in vivo. [ABSTRACT FROM AUTHOR]

Scars resulting from deliberate self-harm (DSH) represent therapeutically challenging forms of scarring due to their highly variable patterns, with no official therapeutic guidelines available. In this pilot study, we aimed to evaluate the effectiveness and safety of a non-ablative fractional Er:glass 1565 nm laser, as a potential new, minimal-invasive approach for the improvement of DSH scars. Sixteen Caucasians suffering from mature DSH scars were included in this clinical study. Patients received a total of three treatments using a non-ablative fractional 1565 nm Er:glass laser every 4 weeks, employing two passes (300 μbeams/cm2, 40 mJ, onto the scar; 150 μbeams/cm2, 50 mJ, overall area). Measurements included questionnaires (DLQI, POSAS), digital photography, and objective three-dimensional analysis using PRIMOS and VECTRA software at baseline, 1 and 6 months after treatment. PRIMOS objective measurements showed highly significant changes in scar surface with a reduction of atrophic lesions by 27.5% at 6 months follow-up (FU), a decrease in scar height by 42.7% at 6 months FU, resulting in an overall diminished skin irregularity dropping from 678.3 μm at baseline to 441.6 μm throughout the course of the study (p = <0.001 respectively). Improvements in objective measurements were supported by clinical evaluation of scar parameters and showed a strong correlation with enhanced life quality of treated patients. Procedures were well-tolerated, with no lasting negative side effects and little to no downtime. The use of a fractional non-ablative 1565 nm Er:glass laser represents a promising and safe approach for the therapy of DSH scars. Although these scars will never fully resolve, their appearance can be significantly improved to a cosmetically and socially more acceptable appearance. [ABSTRACT FROM AUTHOR]

This study explored Pasifika peoples' understandings of Deliberate Self-Harm (DSH) based on the perspective of Pacific health professionals in New Zealand. A total of 20 informants were interviewed using semi-structured Talanoa methods. Informants held professional roles in the mental health, social and addiction sectors in Auckland, (female, n = 10, male, n = 10). DSH was defined as an intentional act of inflicting harm to the physical, mental or spiritual self, and served separate functions from suicidal intent. DSH was defined to include both direct self-harm, as well as indirect forms of self-harm over time including, alcohol and drug misuse, gambling, self-starvation and risk taking behaviours. Intentional harm to the spiritual or the mental self included deliberate disconnection from spiritual faith and holding adverse perspectives and worldviews. [ABSTRACT FROM AUTHOR]

Dieser Artikel berichtet über ein Projekt des Internationalen Studienzentrums der Goethe Universität Frankfurt am Main zur Überprüfung der Konstruktvalidität der DSH. Dem Testkonstrukt der DSH liegen die sprachlichen Fähigkeiten zugrunde, die ausländische Studierende aufweisen müssen, um ein Studium in Deutschland aufnehmen zu können: die sprachliche Studierfähigkeit. Sie ist konstitutiv für die Sozialisierung in den wissenschaftlichen Alltag an deutschen Hochschulen. Allerdings sind zentrale Anforderungen der sprachlichen Studierfähigkeit noch nicht ausreichend untersucht worden. Ausgangspunkt des Projekts sind deshalb linguistische Untersuchungen zu dem in der DSH-Prüfungspraxis verwendeten sprachlichen Material. Dabei berichten wir hier über eine exemplarische Gegenüberstellung von Prüfungsmaterial aus dem Teilbereich des Leseverstehens und der wissenschaftssprachlichen Strukturen mit authentischen Beispielen der alltäglichen Wissenschaftssprache mittels funktional-pragmatischer Analysekategorien. This paper describes a project carried out by the Internationales Studienzentrum at the Goethe University Frankfurt. The project investigates the construct validity of the German language university entrance exam DSH (Deutsche Sprachprüfung für den Hochschulzugang). At its core the construct of DSH encompasses the linguistic abilities necessary to start studying at university level (sprachliche Studierfähigkeit). But, as was shown repeatedly, central aspects of the sprachliche Studierfähigkeit are yet unclear and need to be further specified. The starting point of the project was, therefore, to take authentic examples of the Alltägliche Wissenschaftssprache (language for academic purposes) and confront it with linguistic structures of an authentic DSH by means of categories developed in Functional Pragmatics. The linguistic material examined in this paper is taken from two of DSH's subtests: Leseverstehen (reading comprehension) and Wissenschaftssprachliche Strukturen (grammar phenomena typical in German language for academic purposes). [ABSTRACT FROM AUTHOR]

The aim of the present study is to investigate deliberate self-harm (DSH) in Bosnia and Herzegovina (BiH), with special reference to gender, age and ethnicity. Between 2001 and 2003, known hospital cases of DSH in persons aged 15 or older in the Sarajevo area were monitored using standardised methods. In total, 1428 DSH events were registered, giving an annual mean DSH event rate of 119 per 100 000 (118 for women, 120 for men) and a DSH person rate of 110 (108 for women, 111 for men). The mean person-based DSH rate was 124 for Bosniaks (Muslims), 128 for Croats (Catolics), and 88 for Serbs (Orthodox Christians). Self-poisoning was the most commonly used method in all three ethnic groups (66%), with second-most common method self-harm by a sharp object (17%). A very low proportion used guns or explosives. The rates of DSH in Sarajevo during the study period were comparable to those of many other regions in Europe, though with a quite unique pattern of higher rates among men. We identified fluctuating but significantly not different rates between ethnic groups. The general belief that religious denomination is decisive for level of DSH-rates was not supported by the findings of this study; rather the post-war situation with huge demographic changes was reflected in the results. Disruptions to social integration as a consequence of the war are put forward as possible explanations. [ABSTRACT FROM AUTHOR]

Aiming at the problems of traditional software defect tracking and management system such us poor user experience and low business efficiency etc.,a software defect tracking management system based on DSH architecture was designed and realized. The system was constructed by B/S mode, using Dorado presentation middleware and mainstream Java Web technology such as Spring, Hibernate, etc. The system realized the functions of project management, user management, defect tracking management, defect data statistical analysis, report output and so on. The application practice has indicated that it improved the page graphics display and user experience, had good scalability and maintainability, and was suitable for defect tracking of small and medium scale software development. [ABSTRACT FROM AUTHOR]

Abelson (Abl) family tyrosine kinases have been implicated in cell morphogenesis, adhesion, motility, and oncogenesis. Using a candidate approach for genes involved in planar cell polarity (PCP) signaling, we identified Drosophila Abl (dAbl) as a modulator of Frizzled(Fz)/PCP signaling.We demonstrate that dAbl positively regulates the Fz/Dishevelled (Dsh) PCP pathway without affecting canonical Wnt/Wg-Fz signaling. Genetic dissection suggests that Abl functions via Fz/Dsh signaling in photoreceptor R3 specification, a well-established Fz-PCP signaling readout. Molecular analysis shows that dAbl binds and phosphorylates Dsh on Tyr473 within the DEP domain. This phosphorylation event on Dsh is functionally critical, as the equivalent DshY473F mutant is nonfunctional in PCP signaling and stable membrane association, although it rescues canonical Wnt signaling. Strikingly, mouse embryonic fibroblasts (MEFs) deficient for Abl1 and Abl2/Arg genes also show reduced Dvl2 phosphorylation as compared with control MEFs, and this correlates with a change in subcellular localization of endogenous Dvl2. As in Drosophila, such Abl-deficient MEFs show no change in canonical Wnt signaling. Taken together, our results argue for a conserved role of Abl family members in the positive regulation of Dsh activity toward Fz-Dsh/PCP signaling by Dsh phosphorylation. [ABSTRACT FROM AUTHOR]

The process of epithelial morphogenesis defines the structure of epidermal tissue sheets. One such sheet, the ventral epidermis of the Drosophila embryo, shows both intricate segmental patterning and complex cell organization. Within a segment, cells produce hairlike denticles in a stereotypical and highly organized pattern over the surface of the tissue. To understand the cell biological basis of this process, we examined cell shapes and alignments, and looked for molecules that showed an asymmetric distribution in this tissue. We found that apical polarity determinants and adherens junctions were enriched at the dorsal and ventral borders of cells, whereas basolateral determinants were enriched at the anterior and posterior borders. We report that the basolateral determinant Lgl has a novel function in the planar organization of the embryonic epidermis, and this function depends on Dsh and myosin. We conclude that apical-basal proteins, used to establish polarity within a cell, can be independently co-opted to function in epithelial morphogenesis. [ABSTRACT FROM AUTHOR]

• The dsh is a GA-deficient mutant and useful germplasm resource. • Mutations in the promoter of ClaGA20ox2 mediate the dwarfism. Developing dwarf watermelon is a major objective among breeders. The dsh dwarf watermelon germplasm developed in our laboratory is genetically stable. We previously produced preliminary evidence that Cla010726 , which encodes a gibberellin 20-oxidase-like protein, is the primary gene controlling dwarfism in watermelon. However, the underlying genetic mechanism was unknown. In this study, we characterized the spontaneous recessive mutant dsh , which is a gibberellin (GA)-deficient mutant. Many of the phenotypic traits of dsh plants are similar to those of known GA-deficient mutants. The dsh plants were sensitive to exogenous bioactive GAs, which increased seedling height. Moreover, a quantitative analysis of endogenous GA 3 proved that the bioactive GA 3 content was substantially lower than normal in dsh. Additionally, the T 5 ClaGA20ox RNAi plants generally exhibited dwarfism, with short stems and internodes as well as small leaves and fruit. An examination of the transgenic plants carrying the ClaGA20ox1 promoter-GUS and mutant ClaGA20ox2 promoter-GUS constructs confirmed that two promoter sites are involved in the regulation of ClaGA20ox expression. Hence, mutations in the promoter of the GA20ox gene, which encodes a key enzyme involved in gibberellin biosynthesis, lead to the dwarfism of watermelon plants. The dsh mutant is a potentially useful germplasm resource for developing new watermelon varieties exhibiting dwarfism. [ABSTRACT FROM AUTHOR]

Dyschromatosis universalis hereditaria (DUH) and dyschromatosis symmetrica hereditaria (DSH) are pigmentary dermatoses most commonly seen in Japan. Both disorders usually show autosomal dominant inheritance, although in some cases autosomal recessive inheritance was reported. DSH was mapped to chromosome 1q21.3, and mutations in the gene ADAR ( DSRAD) were identified in Japanese, Chinese and Taiwanese families with autosomal dominant DSH. A second locus for dyschromatosis was mapped on chromosome 6q24.2-q25.2 in two Chinese families initially reported to be affected with DSH, but later suggested to have autosomal dominant DUH. The aim of this study was to investigate whether one of these two loci is involved in the development of DUH in a consanguineous Bedouin family from Saudi Arabia with four affected and three unaffected sibs, clearly pointing to autosomal recessive inheritance. After excluding mutations in ADAR and linkage to the candidate regions on chromosomes 1 and 6, we performed an single nucleotide polymorphism-based genome-wide scan for linkage with other loci. Under the assumption of autosomal recessive inheritance, we have identified a new locus for dyschromatosis on chromosome 12q21-q23 in this Arab family with a maximum logarithm of the odds (LOD) score of 3.4, spanning a distance of 18.9 cM. Our study revealed the first locus for autosomal recessive DUH and supports recent evidence that DSH and DUH are genetically distinct disorders. [ABSTRACT FROM AUTHOR]

Abstract: Convergent extension (CE) movements in gastrulation are essential for the establishment of the body axis during early vertebrate development. Although the precise molecular mechanisms of CE movements are not clearly understood, noncanonical Wnt pathway is known to be important for the control of CE movements. Here, we present evidence that PKA is implicated in noncanonical Wnt pathway. Overexpression and specific depletion of PKA inhibit CE movements. PKA depletion also disrupts cell morphology, protrusive activity, and cortical actin formation in dorsal mesodermal cells. Moreover, PKA activity is negatively regulated by major components of planar cell polarity (PCP) pathway. In line with this, overexpression of PKA can rescue the inhibition of CE movements caused by overexpression of these molecules. We also demonstrate that this regulation of PKA activity is dependent upon Gαi signaling. As a negative component of PCP signaling, PKA inhibits not only the activation of RhoA and JNK but also the Dsh-Daam1-RhoA complex formation which is essential for the regulation of RhoA activity. Together, our study suggests a molecular pathway from Wnt/Dsh/PKA signaling to Rho activation in PCP signaling. [Copyright &y& Elsevier]

Despite implicating the same biological systems, the relationship between suicide seasonality and season–of–birth has not been examined previously. The purpose of this study was to investigate the interaction between season–of–birth and the seasonality of suicidal behaviour. All adult suicides (N = 2923) and deliberate self harm (DSH) hospitalizations (N = 33321) in Western Australia (1970–96) were examined. A variable population at risk approach was used to determine season–of–birth. Seasonality was established by spectral analysis. We found that DSH has a significant season–of–birth (p = 0.047) and seasonality of occurrence, both peaking in spring. Individuals born in the 90 days centred on the peak birth period, however, show no DSH seasonality. In contrast, suicide has no season–of–birth (p = 0.53). We also found a season–of–birth effect among the DSH group that eliminates any seasonality of DSH among the high–risk by birth group. Further work is needed to identify the possible biological and environmental determinants of this interaction. [ABSTRACT FROM AUTHOR]

Wnt proteins transmit myriad intercellular signals crucial for the development and homeostasis of metazoan animals from Hydra to human. Abnormal Wnt signaling causes a growing number of diseases, including cancer and osteoporosis. Depending on the context, a given Wnt signal may denote: cell proliferation or apoptosis; cell fate determination, differentiation, or stem cell maintenance; a variety of changes in cell behavior; and/or coordinated interactions with its neighbors. Which event(s) occur in Wnt-responsive cells depends critically on the ability of Dishevelled (Dsh)/Dvl proteins to interpret distinct types of intracellular, receptor-generated stimuli and transmit them to at least two distinct sets of effector molecules, all while apparently ignoring a third type of Wnt-generated Ca2+ signal. The three conserved domains present in Dsh/Dvl proteins uniquely function in each Wnt pathway, in part by association with 18 (and counting) Dsh/Dvl-associated proteins. The latest data suggest that Dsh/Dvl proteins organize dynamic, pathway-specific subcellular signaling complexes that ensure correct information routing, signal amplification, and dynamic control through feedback regulation. The biochemical and cell biological mechanisms by which Dsh/Dvl proteins accomplish these remarkable tasks remain obscure. [Copyright &y& Elsevier]

The article discusses a novel deletion mutation of double-stranded RNA-specific adenosine deaminase (ADAR1) gene that results in a frameshift mutation in a 20-year-old Chinese patient with dyschromatosis symmetrica hereditaria, a rare pigmentary genodermatosis of autosomal dominant inheritance. Topics include the quantity and location of melanocytes based on the results of toluidine blue staining, and the medical history of the patient.

Summary: Background: There are currently limited treatment options available to modify the appearance of scarring due to deliberate self-harm (DSH). The authors present two cases of Integra dermal matrix use for resurfacing scars due to past DSH. Methods: By excising the scars and resurfacing with Integra, we present and describe a novel technique for treating the visible stigmata of previous DSH. Results: No complications occurred, and patients noted improved appearance, skin quality and self-esteem following surgery. Both patients would recommend this treatment to others. Conclusions: Integra dermal matrix substitute may be used successfully to treat scarring from previous DSH. [Copyright &y& Elsevier]