Nasal ala V-Y island flap with a superior vascular pedicle based on inferior perforators of the superior alar artery.

For small defects of the anterior nasal ala, a V-Y pedicle advancement flap within the subunit is a useful repair option. Here we propose a modification of this technique, utilising careful dissection to identify inferior perforators of the superior alar artery. Basing this flap on a visualised vascular pedicle aims to prevent common complications of internal mucosal buckling and free margin notching, by allowing more extensive dissection without compromising the vascularity of the flap.

Efficacy of secondary intention healing for scalp defects-Case series from a single institution.

BACKGROUND/OBJECTIVES: As surgical techniques evolve, there remains underutilisation of secondary intention healing as a valid reconstruction option. This is largely due to concerns regarding inferiority of wound cosmesis, increased downtime with wound healing and infection risk (Dermatol Surg. 2020; 46(12): 1492-97). METHODS: We sought to look at the outcome of secondary intention healing in a cohort of patients seen at a private dermatology practice with small to medium sized scalp defects. All patients completed a satisfaction survey that further evaluated its feasibility. RESULTS: Excellent cosmetic outcome was noted with secondary intention healing for small to medium scalp defects, specifically in patients with thinning scalps that allowed healing without patchy alopecia. CONCLUSIONS: Secondary intention healing should be considered as a reconstructive option for scalp defects, especially in the right patient cohort.

Perineural invasion present exclusively in central tissue blocks of Mohs surgical excisions of basal cell carcinoma.

Perineural invasion (PNI) may be present in basal cell carcinomas (BCC) treated with Mohs micrographic surgery. This single-centre, non-randomised, prospective study demonstrates the potential for PNI to exist exclusively within the central tissue blocks of Mohs specimens.

Glove imprint templating: A versatile tool in skin graft surgery and more.

Measurement of the shape and size of skin lesions is an important component of skin excision and repair, especially in full-thickness skin grafting. Current templating methods can be time-consuming and may lead to inaccurate sizing of both full-thickness and split-thickness skin grafts. A novel, accurate, and time-efficient method has been employed for 10 years in a dermatology clinic, in addition demonstrating utility in additional applications. A surgical glove is used to gain an imprint of a marked surgical incision site, to transcribe to the donor site for graft harvest. Further, the size of lesions in difficult-to-see areas of the body can be shown to patients. This method has been found to be clinically useful in reducing procedure times and providing accurate graft templates, as well as improving patients' satisfaction by helping them to understand the procedure. This method is also advantageous in obtaining informed consent by helping to clearly demonstrate the size of simple elliptical excisions.

Cutaneous mastocytosis extending beyond a radiotherapy site: a form of radiodermatitis or a neoplastic phenomenon?

Ionising radiation is often used as an adjuvant in the management of breast cancer. Acute and chronic skin changes are well recognised complications associated with its use. We demonstrate a rare clinical presentation of cutaneous mastocytosis that occurred at the site of radiotherapy and then extended beyond this boundary, and ask whether this can be treated as a localised side effect of radiotherapy or whether the potential for systemic mastocytosis needs to be excluded.