الفهرس 
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Abstract
Scar formation is the natural consequence of large or deep wounds in adult mammals. Skin tissue repair results in a broad spectrum of scar types, ranging from a “normal” fine line to a variety of abnormal scars, including stretched, atrophic, contracted and raised scars. Raised scars are further classified as hypertrophic or keloid scars. Wound healing is divided into haemostasis, inflammation, proliferation and tissue remodeling. In these four stages, there are complicated interactions within a complex network of profibrotic and antifibrotic molecules, such as growth factors, proteolytic enzymes and ECM proteins. HTS are red, raised and mostly linear scar occurred in any regions of the body, do not grow beyond the boundaries of the original wound while keloids appear as pink to purple, shiny, rounded protuberance and are commonly seen in sternal skin, shoulder, upper arms and earlobe spreading into the surrounding normal skin. Keloids and hypertrophic scars are multifactorial disorders that are driven by genetic predisposition, systemic conditions, and local wound conditions, including mechanobiological dysregulation of the dermis and blood vessels. The balance between these factors may determine whether a wound becomes a keloid, hypertrophic scar, or normal scar. As the skin is a sensitive and important, sexual organ, disfiguring scars might affect sexuality and skin sensitivity. On top of that, alteration in appearance may affect an individual’s body image and self-esteem, which are import factors in sexual life. Female sexual dysfuntion is relatively common, but women seldom seek medical help. The problem is often multifactorial. Criteria for sexual function disorder require the presence of at least three specific symptoms lasting for at least six months. Life¬long anorgasmia may suggest the patient is unfamiliar or uncomfortable with self-stimulation or sexual communi¬cation with her partner. Delayed or less intense orgasms may be a natural process of aging due to decreased genital blood flow and dulled genital sensations. Genito-pelvic pain/penetration disorder includes fear or anxiety, marked tightening or tensing of the abdominal and pelvic muscles, or actual pain associated with attempts toward vaginal penetration that is persistent or recurrent for at least six months. Treatment depends on the etiology. Estrogen is effective for the treatment of dyspareunia associated with genitourinary syndrome of menopause. Testosterone, with and without concomitant use of estrogen, is associated with improvements in sexual functioning in naturally and surgically menopausal women, although data on long-term risks and benefits are lacking. Psychotherapy or sex therapy is useful for management of the psychological, relational, and sociocultural factors impacting a wom¬an’s sexual function. The current study assessed the sexual function in married women with disfiguring scar(s) and examined the effects of scar severity, type and location on their sexuality and quality of life. This study included 100 married women with disfiguring scar(s) recruited from the outpatient clinic of dermatology, andrology and STDS department, Mansoura University Hospital with Plastic and Burn center. The mean age of the cases was 35.33±5.05 years with range between 25 and 48 years. The median range of the duration of marriage was 10 years with range between 4 and 26 years. The Arabic version FSFI established by Anis et al., (2011) and DLQI questionnaires translated in Arabic version were taken in the outpatient clinic of dermatology, andrology and STD department, Mansoura University Hospital with plastic and burn center. MSS was assessed in women with disfiguring scar. Informed consents were obtained from all participants in this study. The Arabic version of FSFI questionnaire was used to assess female sexual dysfunction in women with disfiguring scar(s). There was a statistically significant negative correlation between total MSS with Desire, Arousal, Lubrication, Orgasm, and Satisfaction domains and total FSFI. Also, there was a statistically significant negative correlation between total MSS with pain domain. The females with scars found in chest, forehead, face ad scalp and thigh had statistically significant reduction in the total FSFI score as compared with females with no affection of these sites. DLQI was used to measure the effect of disfiguring scar on patient’s life over the last week. There was a statistically significant strong positive correlation between total MSS and DLQI. Also there was no statistically significant difference in the mean DLQI between different types of scars. The majority of cases with different types of scars showed large affection, but it revealed no statistically significant difference. In conclusion, to the best of our knowledge, no previous studies have compared both quality of life and the sexual functions (assessed by DLQI and FSFI respectively) in these different types of scars together. Our study reveals that scars are associated with negative impacts on quality of life and different aspects of sexual life of the affected women.