That single introduction at the Forum led to the formation of a national group of clinical leaders focused on scaling proactive patient and family escalation beyond a single service. Leaders from multiple Australian states began meeting regularly to share data, align approaches and test feasibility across different healthcare contexts.

This group evolved into a nationwide community of practice that has now met regularly for several years. It has supported collaborative research, shared implementation learning and coordinated rollout across jurisdictions, demonstrating the progression of the project from local improvement to system-level adoption.

The post Recognising deterioration earlier by partnering with families first appeared on BMJ Group.

“Having an unusual case and exposing it to the medical fraternity is important, and I love it that BMJ Case Reports does that. It became a big issue in Australia. I hope this report raises awareness on nutritional deficiencies and encourages clinicians to screen for them in patients with risk factors.”

Dr Andrew Dermawan
General Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia

The post ‘Renaissance era’ diagnosis of scurvy in today’s bariatric population first appeared on BMJ Group.

Condition often poorly recognised, diagnosed, managed and researched, say report authors
This has prompted unfounded fears, particularly on social media, that all steroids are harmful

There is little awareness, particularly among clinicians, of the medical and psychological complexities of ‘topical steroid withdrawal’—the body’s adverse response to the prolonged use of these powerful creams to treat inflammatory skin conditions when they are either tapered or suddenly stopped—warn doctors in the journal BMJ Case Reports.

The condition, also known as ‘TSW syndrome,’ ‘steroid addiction,’ and ‘red burning skin syndrome,’ is poorly recognised, diagnosed, managed, and researched, say the report authors, one of whom speaks from direct experience.

This has prompted unfounded fears, particularly on social media, that all steroids are harmful and should be avoided in favour of other often untested, unproven remedies, they caution.

Steroid creams are widely used for the treatment of various inflammatory skin conditions, such as eczema and psoriasis, for which they are very effective, note the report authors.

They are available in 4 different strengths, ranging from mild to very strong.

But withdrawing treatment—particularly the stronger formulations—after protracted use can prompt a rebound flare-up of symptoms, which can be even more severe and debilitating than the original condition, they point out.

These symptoms can spread well beyond the original areas of treatment and additionally trigger insomnia and depression.

The underlying causes are only partially understood, while diagnosis can be tricky because of the highly variable presenting symptoms, they add.

In a bid to promote wider recognition of the syndrome, the report authors present a case exemplifying some of the challenges involved for both clinicians and patients.

The case involved a middle-aged woman with a history of atopic eczema since infancy that  had been treated with varying strengths of steroid creams for sometimes lengthy periods.

She was referred to dermatology for review and explained that she had had a flare-up of symptoms which had persisted for 18 months until she was treated with a gradually tapering 4-week course of steroid tablets.

She had significant skin thinning, particularly on her arms, and thickened leathery skin (lichenification) in the folds of her elbows and wrists.

She was prescribed further steroid creams to ward off future flare-ups, which she decided to stop using a month after her review. Her skin symptoms then significantly worsened as did her general health.

She had widespread skin reddening and experienced a burning sensation and intense itching. Her skin became dry, scaly, thickened and cracked, exposing deep tears in parts.

She also reported swelling in the thighs, feet, ankles, and around the eyes and extensive skin folds and sagging. Systemic symptoms included dizziness, nausea, hair loss, insomnia, low blood pressure, extremes of temperature and sensations of dampness and numbness. She experienced intense nerve pain and sharp jolts of pain akin to an electric shock. Her symptoms were incapacitating.

She suspected topical steroid withdrawal. It took 28 months for her symptoms to resolve, during which time she decided against any further treatment, even skin moisturisers. She has since experienced occasional mild flare-ups but has not applied steroid creams.

Commenting on her experience, she explains that at times the severity and extent of her symptoms left her unable to get out of bed, and feeling like she might die.

She writes: “I should have liked to have been supported to withdraw safely. Without a diagnosis, this was not possible: I was being treated for eczema, which included continued steroid treatment. It is my understanding that TSW patients will not recover while steroids are part of their recovery plan.”

She continues: “I am pleased that more is now known about TSW, but I should like to see TSW diagnoses routinely being considered where steroids are no longer controlling a patient’s skin or when a patient simply feels that something is ‘different’ to usual. More than that, I should like to see TSW prevention a priority, so that there is no new generation of patients who have to endure the suffering that I have endured.”

The report authors acknowledge: “Despite the increasing recognition of TSW within the dermatological community, it remains underdiagnosed in routine practice. Patients often turn to online forums and self-treatment due to diagnostic challenges, which can lead to inconsistent or even harmful practices.”

They continue: “While social media has raised awareness for poorly recognised conditions like TSW, it has significantly contributed to steroid phobia. From our medical experience, exposure to alarming online narratives has led many patients to refuse [topical steroid] management of their conditions, both dermatological and otherwise, despite reassurance by clinicians about their safe and approved use.”

They conclude: “Breaking the cycle of distrust and enhancing patient care requires clinicians to address patients’ concerns with empathy, prioritising patient education. By fostering open discussions about patients’ beliefs and perspectives while simultaneously providing evidence-based recommendations, clinicians can support well-informed decision making and improve treatment outcomes.

16/12/2025

Notes for editors
Please note, personal details of the case reported here aren’t available for reasons of patient confidentiality.

Case report: Topical steroid withdrawal: a serious, under- recognised skin condition Doi: 10.1136/bcr-2024-264476
Journal: BMJ Case Reports

Link to Academy of Medical Sciences press release labelling system http://press.psprings.co.uk/AMSlabels.pdf 

Externally peer reviewed? Yes
Evidence type: Case report
Subjects: People

The post Little awareness of medical + psychological complexities of steroid cream withdrawal first appeared on BMJ Group.

Fit man in his 50s who drank 8 cans daily developed extremely high blood pressure
Tighter regulation of sales and advertising of these drinks needed, urge report authors

Downing several strong energy drinks every day may pose a serious stroke risk, doctors have warned in the journal BMJ Case Reports, after treating an otherwise fit and healthy man in his 50s with a daily 8-can habit and exceedingly high blood pressure.

The findings prompt the authors to call for tighter regulation of the sales and advertising of these drinks, particularly given their popularity among young people.

The man in question had a stroke in his thalamus—the part of the brain involved in sensory perception and movement. His symptoms included left-sided weakness, numbness, as well as difficulties with balance, walking, swallowing and speech—collectively known as ataxia.

On admission to hospital his blood pressure was 254/150 mm Hg, which is regarded as extremely high.

He was started on drugs to lower his blood pressure, and his systolic blood pressure—reflecting arterial pressure during the heart’s pump action—fell to 170 mm Hg.

But once back home, his blood pressure rose again and remained persistently high despite the ramping up of his drug treatment.

On further questioning, he revealed that he drank an average of 8 energy drinks every day, each of which contained 160 mg of caffeine, adding up to a daily intake of 1200-1300 mg of caffeine: the recommended maximum daily intake is 400 mg.

He was asked to give up this daily habit, after which his blood pressure returned to normal and blood pressure lowering drugs were no longer needed.

But he didn’t regain full feeling on his left side. Commenting on the experience, he said: “I obviously wasn’t aware of the dangers drinking energy drinks were causing to myself. (I) have been left with numbness (in my) left hand side hand and fingers, foot and toes even after 8 years.”

The report authors point out that the man’s lack of awareness about the potential cardiovascular risks associated with heavy energy drink consumption is probably not surprising as they aren’t generally thought of as a potential cardiovascular disease risk.

“The year 2018 saw major UK supermarkets implement a voluntary ban on sales of [these drinks] to under 16s in a drive to tackle obesity, diabetes, and tooth decay, but less explored are the possible increased risks of [energy drinks] for cardiovascular disease, including ischaemic [restricted blood supply or blood clot] and haemorrhagic [bleed in the brain] strokes, particularly in younger demographics otherwise expected to have lower stroke risk,” they emphasise.

Energy drinks contain more than 150 mg of caffeine per litre and typically have a very high glucose-based sugar content and varying quantities of other chemicals, they highlight.

“This declared amount is the ‘pure caffeine’, but other ingredients contain ‘hidden caffeine’— for example, guarana is thought to contain caffeine at twice the concentration of a coffee bean.

“The hypothesis is that the interaction of these other ingredients, including taurine, guarana, ginseng and glucuronolactone, potentiates the effects of caffeine heightening stroke [cardiovascular disease] risk through numerous mechanisms,” they explain.

“The average [energy drink] is said to contain around 80 mg of caffeine per 250 ml serving, compared with 30 mg in tea and 90 mg in coffee, but in some cases can contain up to 500 mg in a single serving,” they point out.

This report represents just one case, but the authors nevertheless conclude: “While the current evidence is not conclusive, given the accumulating literature, the high morbidity and mortality associated with stroke and [cardiovascular disease] and the well-documented adverse health effects of high-sugar drinks, we propose that increased regulation of [energy drink] sales and advertising campaigns (which are often targeted at younger ages) could be beneficial to the future cerebrovascular and cardiovascular health of our society.”

09/12/2025

Notes for editors
Please note, personal details of the cases reported here aren’t available for reasons of patient confidentiality.
Case report:  Energy drinks, hypertension and stroke  Doi: 10.1136/bcr-2025-267441
Journal: BMJ Case Reports

Link to Academy of Medical Sciences press release labelling system http://press.psprings.co.uk/AMSlabels.pdf 

About the journal
BMJ Case Reports is one of 70 journals published by BMJ Group.
https://casereports.bmj.com

Externally peer reviewed? Yes
Evidence type: Case report
Subjects: People

The post Heavy energy drink intake may pose serious stroke risk, doctors warn first appeared on BMJ Group.

When Dr Clara Maarup Prip, a urologist and gynaecologist at Aarhus University Hospital, Denmark, encountered a rare case of kidney swelling (ureterohydronephrosis) caused by a menstrual cup, it was unlike anything she had seen before.

The menstrual cup had been compressing the ureter where it enters the bladder, leading to a serious but rare complication. After searching the literature and finding only a handful of similar cases worldwide, Dr Maarup Prip documented the case and submitted the report titled, “Ureterohydronephrosis due to a menstrual cup” to BMJ Case Reports, choosing the journal based on its reputation and guidance from experienced colleagues.

Dr Maarup Prip didn’t expect the case report to go viral. Published in BMJ Case Reports in February 2025, the paper caught the attention of health journalists worldwide as a direct result of it being press released by BMJ Group’s media relations team. Within weeks, it had become the basis of 29 news stories from 23 major international outlets. It also prompted four opinion pieces in the UK, the USA, and Russia.

Spotlight on safety

Raised global awareness

of a rare but serious risk of uterohydronephrosis linked to menstrual cup use

25,000+ views

of the study in the first month alone

29 media stories

across 23 major international outlets

Featured on the BBC World Service Newshour programme

and picked up by journalists in the UK, Germany, and the USA

Sparked four opinion pieces in the UK, the USA, and Russia,

prompting professional and public discussion

Altmetric score of 234,

placing it in the top 5% of all tracked research outputs

Triggered practical guidance

Many news outlets included safety advice and how-to videos for the public

Demonstrated value with no funding required,

just a sharp clinical eye and the right publishing partner

“The submission process was straightforward, and the response was fast. I’d had other papers published with other publishers, and this was by far the smoothest experience.”

Dr Clara Maarup Prip
Aarhus University Hospital, Denmark

The post Raising awareness of a rare but serious risk linked to menstrual cup use first appeared on BMJ Group.

Warning comes after lopsided placement blocked urine flow into the bladder

A poorly positioned menstrual cup to capture monthly blood flow may lead to more serious complications than leakage alone, warn doctors in the journal BMJ Case Reports, after treating a young woman with uterohydronephrosis—a swollen kidney caused by blocked urine flow into the bladder.

The use of menstrual cups as a sustainable alternative to other methods of controlling period blood flow is rising, note the report authors. While reported complications are rare, the evidence suggests that pain, vaginal wounds, allergic reactions, leakage, urinary incontinence, dislodgement of intrauterine devices (‘coils’), and infections, are all possible, they add.

The doctors treated a young woman in her early 30s who had noticed blood in her urine and was experiencing intermittent right-sided flank and pelvic pain that had lasted for around 6 months.

Three years earlier, she had had a 9 mm kidney stone removed. And she was using a copper coil for contraception. One or 2 days a month, during the heaviest period blood flow, she used a menstrual cup which she emptied every 2–3 hours.

A scan revealed no signs of kidney stones, but it did show a swollen right kidney and ureter—the tube that carries urine away from the kidneys. It also showed a menstrual cup positioned right next to the opening of the ureter into the bladder (ureteral ostium).

The woman was asked not to use the menstrual cup during her next period and to return for a follow up scan a month later. The scan showed that the swelling had gone down and that urine was draining normally from both kidneys.

The woman’s symptoms had cleared up completely, prompting the report authors to conclude that the cup had obstructed the flow of urine from the right ureter.

When the woman attended for a further check-up six months later, she said that she had only used the menstrual cup occasionally for 3–4 hours at a time during visits to a swimming pool. She hadn’t wanted to use the cup regularly again, for fear of possible complications.

“To our knowledge only a few similar cases have previously been reported. [These] cases were similar to our case,” note the report authors.

“In all cases except one, a follow-up [computed tomography scan] or ultrasound was performed which showed regression of the ureterohydronephrosis. In three cases, the women resumed use of the menstrual cup, and none of them experienced resumption of symptoms (unknown follow-up periods). One of them chose a smaller sized cup,” they write.

Women (and clinicians) need to be better informed about the correct use (and potential complications) of menstrual cups, suggest the report authors.

“When the terminal part of the ureters passes into the bladder, they are in close proximity to the vagina, which can affect urinary drainage from the ureter. Correct positioning, along with choosing the correct cup shape and size, is important to prevent negative effects on the upper urinary tract,” they explain.

“Presently, menstrual cups can be bought and used without clinical advice from a health professional, which emphasises the importance of detailed and clear patient information material,” they add.

11/02/2025

Notes for editors
Please note, personal details of the cases reported here aren’t available for reasons of patient confidentiality.

Case report: Ureterohydronephrosis due to a menstrual cup  Doi:10.1136/bcr-2024- 262035
Journal: BMJ Case Reports

External funding: None declared

Link to Academy of Medical Sciences press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf  

Externally peer reviewed? Yes
Evidence type: Single case report
Subjects: People

The post Position menstrual cups carefully to avoid possible kidney problems, doctors urge first appeared on BMJ Group.

Although rare, condition can be life threatening, even in absence of various risk factors

Basking too long in a sauna may put bathers at risk of heat stroke, particularly if they haven’t drunk enough water beforehand, warn doctors in the journal BMJ Case Reports, after treating a woman whose condition required admission to hospital.

Although relatively rare, heat stroke can be life threatening, even in the absence of various underlying risk factors, such as heart, lung, or neurological disease, and heavy drinking or taking a cocktail of prescription meds, they point out.

Heat stroke is defined as a sharp increase in core body temperature above 40°C that is associated with acutely impaired brain function, and ‘non-exertional’ heat stroke results from prolonged exposure to high environmental temperatures, explain the authors.

They treated a woman in her early 70s who had been found unconscious in her local gym’s sauna, where she had been doing stretching exercises for around 45 minutes.

Her core body temperature was 42°C—normal temperature is 36.4°C—her blood pressure was extremely low, and her heart rate was extremely high. She had a seizure after her arrival in emergency care.

She had previously been diagnosed with type 1 diabetes and an underactive thyroid, but she wasn’t a smoker or heavy drinker, and was a regular gym goer, so had few risk factors, point out the authors.

She was rapidly cooled with wet towels and a fan and given intravenous fluids and blood products to stabilise her.

Blood tests revealed malfunctioning kidneys and liver, evidence of a minor heart attack, and muscle tissue breakdown (rhabdomyolysis).

She regained consciousness within 2 hours of reaching normal core temperature but was confused and drowsy for 2 days. By day 3 this had resolved and she had no further seizures during her inpatient stay, which lasted 12 days.

After 26 days she had more or less fully recovered, except for some mild fatigue and mild liver function disturbance.

This is just one case report after prolonged sauna use, and as far as the authors are aware, only 9 other similar cases have been reported. But 3 of those people died as a result.

“The prognosis of heat stroke varies according to patient factors, particularly extremes of age,” explain the authors. “Classical heat stroke in elderly people carries a mortality rate of  [more than] 50%, and this increases further with each additional organ dysfunction.

“Heat-related deaths spike during heat waves, as has been observed in multiple large international datasets. Deaths from heat stroke are expected to rise as global temperatures continue to increase,” they add.

“Once heat stroke has occurred, the key determinate of outcome is how rapidly a patient is cooled, as the time spent with elevated core body temperature is correlated to the degree of cellular damage,” they emphasise.

The woman in question comments: “My experience has emphasised the dangers of saunas and how important it is to be fully hydrated on entering a sauna, and for them to be regularly checked by staff. As a regular sauna user, I never suffered any issues and, on reflection, I believe I had not drunk enough water.”

08/01/2025

Notes for editors
Please note, personal details of the cases reported here aren’t available for reasons of patient confidentiality.

Case report: Severe heat stroke with multiorgan failure following collapse in a sauna Doi: 10.1136/bcr-2024-262069
Journal: BMJ Case Report

External funding: None declared

Link to Academy of Medical Sciences press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf  

Externally peer reviewed? Yes
Evidence type: Case report
Subjects: People

The post Basking too long in a sauna without adequate hydration may risk heat stroke, doctors warn first appeared on BMJ Group.

Continued cord friction linked to chronic inflammation, leading to skin ulceration

A tightly tied waist cord of the underskirt (petticoat) traditionally worn under a saree, particularly in rural parts of India, may lead to what has been dubbed ‘petticoat cancer,’ warn doctors in the journal BMJ Case Reports after treating two women with this type of malignancy.

The continued pressure and friction on the skin can cause chronic inflammation, leading to ulceration, and, in some cases, progression to skin cancer, say the authors.

This phenomenon has previously been described as “saree cancer,” but it is the tightness of the waist cord that’s to blame, they point out.

The first case concerned a 70 year old woman who sought medical help because of a painful skin ulcer on her right flank that she had had for 18 months and which wouldn’t heal. The skin in the surrounding area had lost its pigmentation. She wore her petticoat underneath her saree which was tightly tied around her waist.

A biopsy specimen revealed that she had a Marjolin ulcer, also known as squamous cell carcinoma (ulcerating skin cancer).

The second case concerned a woman in her late 60s who had had an ulcer on her right flank that wouldn’t heal for 2 years. She had worn a traditional type of saree called a ‘lugda’ every day for 40 years, tied very tightly around the waist without an underskirt.

A biopsy specimen revealed that she too had a Marjolin ulcer. The cancer had already spread to one of the lymph nodes in her groin when she was diagnosed.

A Marjolin ulcer is rare but aggressive. It develops in chronic burn wounds, non-healing wounds, leg ulcers, tuberculous skin nodules, and in vaccination and snake bite scars, explain the authors.

“The exact process by which chronic ulcers or wounds become malignant is unknown, although many theories have been proposed,” they write. “Every cutaneous lesion that is continuously irritated (chronically inflamed) has been shown to have a higher risk of developing malignant transformation.”

They add: “Constant pressure at the waist often leads to cutaneous atrophy, which ultimately breaks down to form an erosion or an ulcer. The ulcer at this site does not heal entirely due to ongoing pressure from tight clothing. A chronic non-healing wound results, which may develop malignant change.”

They recommend wearing a loose petticoat beneath the saree to ease pressure on the skin, and to wear loose clothing if skin problems develop to allow the area to heal.

Commenting on her diagnosis, the 70 year old said: “I have been wearing a Nauvari saree, tightly wrapped around my waist, for most of my adult life. Six years ago, I noticed a small area of depigmentation on my right flank, which I initially dismissed as a minor skin issue.

“Over time, this spot turned into a non-healing ulcer, causing me concern and discomfort. The discomfort became a part of my daily life, impacting my ability to perform routine tasks. When I finally consulted a dermatologist, I was diagnosed with skin cancer, mostly exacerbated by the chronic friction and pressure from the tightness of the saree tied around my waist.

“This has been a psychologically and physically taxing journey. It shows the importance of paying attention to chronic skin changes and seeking medical advice early. I hope my story will raise awareness among women about the potential health risks associated with traditional clothing practices and encourage timely medical consultation for unusual skin conditions.”

06/11/2024

Notes for editors
Personal details of the cases reported aren’t available for reasons of patient confidentiality.

Case report: Petticoat cancer: Marjolin ulcer of the waist in South Asian women (a site-specific malignancy) Doi: 10.1136/bcr-2024-262049
Journal: BMJ Case Reports

External funding: None declared

Link to Academy of Medical Sciences press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: 2 case reports
Subjects: Women

The post Tightly tied waist cord of saree underskirt may pose cancer risk, warn doctors first appeared on BMJ Group.

Condition caused by vitamin C deficiency first linked to sailors during Renaissance era

The scourge of scurvy, which is caused by vitamin C deficiency, may be re-emerging amid the cost of living crisis and the rise in weight loss (bariatric) surgery, suggest doctors in the journal BMJ Case Reports after treating a middle-aged man with the condition.

Scurvy is eminently treatable, but because it’s a disease of the past, first associated with sailors during the Renaissance era, it may be mistaken for other conditions, especially inflamed blood vessels (vasculitis), potentially risking fatal bleeding if left untreated, highlight the authors.

Signs can appear as early as a month after a daily intake of less than 10 mg of vitamin C.

The authors treated a middle aged man whose legs were covered with tiny painful red-brown pinpoints, resembling a rash. Blood was also present in his urine and he was anaemic.

He tested negative for inflammatory, autoimmune, and blood disorders, and scans revealed no evidence of internal bleeding. Similarly, a skin biopsy returned no diagnostic clues.

His rash continued to spread while he was in hospital. And further questioning revealed that he was short of cash and neglected his diet, eating little in the way of fruit and vegetables. He said that he sometimes skipped meals altogether.

He had also stopped taking the nutritional supplements prescribed for him after previous weight loss surgery, because he said he couldn’t afford them.

Blood tests to assess his general nutritional status indicated no detectable levels of vitamin C and very low levels of other key nutrients. He was diagnosed with scurvy and treated with  daily vitamin C (1000 mg), vitamin D3, folic acid and multivitamin supplements, after which his painful rash and other symptoms cleared up.

This is just one case report, and while it’s not clear what the current prevalence of scurvy is, it’s still relatively rare.

But the authors point out: “Scurvy is still seen as a disease of the past, especially in developed countries.” The rising cost of living also makes it harder for families to afford good quality nutritious foods, while there have been numerous reports of scurvy arising from complications following bariatric surgery, they add.

Other risk factors for scurvy include alcoholism, smoking, eating disorders, low household income, obesity, kidney dialysis and drugs that interfere with vitamin C absorption, such as steroids and those that curb stomach acid production (proton pump inhibitors), they highlight.

“Our patient had multiple risk factors, namely, poor dietary habits, obesity, previous bariatric surgery, use of proton pump inhibitors and low-income status. His history of iron, vitamin D and folate deficiencies were also clues to his underlying nutritional deficiency,” they conclude.

23/10/2024

Notes for editors
Personal details of the cases reported in this journal aren’t available for reasons of patient confidentiality.

Please note: an unedited version of this case report previously posted online due to a technical error.

Case report: Scurvy—a re-emerging disease with the rising cost of living and number of bariatric surgical procedures Doi 10.1136/bcr-2024-261082
Journal: BMJ Case Reports

External funding: None declared

Link to Academy of Medical Sciences press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: Single case report
Subjects: People

The post Scurvy may be re-emerging amid cost of living crisis and rise of weight loss surgery first appeared on BMJ Group.

Condition manifests as protruding scalp lump, plus hair loss and tenderness

Breakdancers may be at risk of developing a condition caused by repeatedly doing a cardinal move of their practice and performance—the headspin—warn doctors in the journal BMJ Case Reports.

Dubbed the ‘headspin hole,’ or ‘breakdance bulge,’ the condition is unique to breakdancers, and appears as a protruding lump on the scalp, often accompanied by hair loss and tenderness.

Breakdancers are particularly prone to injuries because of the complexities and physical demands of the moves, note the authors. Sprains, strains, and tendinitis are particularly common. Head and brain injuries, including subdural haematomas (pooling of blood between the skull and the brain), have also been reported.

Prolonged breakdancing often leads to ‘breakdancer overuse syndrome’ which includes various conditions, such as carpal tunnel syndrome and swollen and inflamed tendons (tenosynovitis) as well as hair loss and scalp irritation, add the authors.

They treated a man in his early 30s with a growth on his scalp. The man said that he had performed various types of headspin manoeuvres for more than19 years.

He practised his moves 5 times a week for around 1.5 hours a time. During these sessions direct pressure was applied to the top of his head for between 2 and 7 minutes.

Despite hair loss and a burgeoning lump on his head, he continued to practise headspins, but was prompted to act when the lump started to grow a lot larger and his scalp began to feel tender.

A head scan revealed thickening of the skin, tissue, and skull around the lump, but no obvious signs of cancer, which was confirmed on biopsy.

The lump was removed, but the surrounding skin tissue remained thickened. Nevertheless, the man was happy with the result and felt able to go out in public once again without having to wear a cap.

This report represents just one case, and details of only one other have been published to date, so the findings should be interpreted in this context.

But the authors conclude: “This case underscores the importance of recognising chronic scalp conditions in breakdancers and suggests that surgical intervention can be an effective treatment.” 

11/10/2024

Notes for editors
Personal details of the cases reported in this journal aren’t available for reasons of patient confidentiality.
‘Headspin hole’: an overuse injury among breakdancers Doi: 10.1136/bcr-2024-261854
Journal: BMJ Case Reports

External funding: None declared

Link to Academy of Medical Sciences press release labelling system
http://press.psprings.co.uk/AMSlabels.pdf

Externally peer reviewed? Yes
Evidence type: Case report
Subjects: People

The post Breakdancers may risk ‘headspin hole’ caused by repetitive headspins, doctors warn first appeared on BMJ Group.