A 7-year Experience with Keloid Fillet Flap and Adjuvant Intralesional Corticosteroids.

CONTEXT: Keloids are fibroproliferative scars characterized by excessive collagen deposition beyond the margins of the original wound. Although many treatment modalities were described in the literature, no single first-line therapy is recommended, and its recurrence rate remains high. AIMS: The aim of this study was to investigate the efficacy rate in treating auricle keloids after fillet flap excision combined with adjuvant intralesional steroid injections. SETTINGS AND DESIGN: This was a retrospective study. MATERIALS AND METHODS: Between 2012 and 2019, a total of 16 auricle keloids were treated at our center with fillet flap excision and adjuvant steroid injections. Intralesional steroid injections were given at the end of the first week and then administered at 4-week intervals until the lesions were soft and flat. Postoperative efficacy, complications, recurrence, and patient satisfaction were analyzed. RESULTS: A high improvement of the keloid was observed in 13 (81.2%) lesions. No major complications and no recurrence of the keloid were detected during the follow-up period (mean, 35 months). Regarding patient satisfaction, nine (81.8%) considered their result as excellent. CONCLUSION: This study showed that this approach is effective regardless of the keloid location at the auricle.

Tunneled Flaps: An Ingenious Reconstructive Option for Anterior Auricle Defects.

BACKGROUND: The anterior surface of the auricle is especially susceptible to a variety of traumatic insults and cutaneous malignancies. However, given the unique anatomy of this structure and the lack of local tissue available, the reconstruction of these defects is still a challenge. Despite of their positive outcomes, tunneled flaps have not been thoroughly explored in the literature. OBJECTIVES: To review the clinical utility of tunneled flaps in reconstructing anterior auricle defects. MATERIALS AND METHODS: A review of the literature on surgical reconstruction of the anterior auricle surface was performed in PubMed, with specific reference to tunneled flaps. CONCLUSIONS: When designed and executed properly, tunneled flaps offer unrivalled opportunities to reconstruct anterior auricle defects, with maximal preservation of the symmetry.

A Retrospective Study of the Safety and Efficacy of a Radial Diode Laser Probe in the Management of Pilonidal Sinus Disease.

BACKGROUND: Recently, the interest in minimally invasive techniques in the management of the pilonidal sinus has been rising. The main goal is to avoid the prolonged recovery period associated with traditional surgeries. OBJECTIVE: To evaluate the safety and efficacy of a radial diode laser probe in the destruction of the pilonidal sinus. METHODS: Twenty-seven patients with pilonidal sinus were treated with a radial 1,470-nm diode laser between July 2018 and August 2020 and were examined retrospectively. Charts were reviewed and patients were questioned by telephone about their postlaser recovery period. RESULTS: Twenty-five patients were included. The overall success rate was 84%. Recurrence rate was 9.5%, after a mean follow-up of 8.3 months. The mean duration of analgesia intake was 2.5 days, and the mean period required to return to daily activities was 5.8 days. Sixteen percent of the patients developed a small postoperative hemorrhage as a complication. CONCLUSION: This study demonstrated that radial diode laser is safe, effective, and associated with a low recurrence rate in the treatment of mild pilonidal sinus disease. Dermatologists can perform it easily in the outpatient clinic, with minimal postoperative pain and a fast return to the patients' daily activities.

Segmental stiff skin syndrome (SSS): Clinical case and a brief review.

Stiff skin syndrome (SSS) is a rare, scleroderma-like condition that is commonly characterised by stony hard skin and limited joint mobility, in the absence of visceral involvement or immunologic abnormalities. Depending on the distribution of the disease, this disorder can be further categorised into classic (widespread) SSS or its newly described segmental variant. Additional features of this syndrome may include hypertrichosis, lipodystrophy, dysmetria and scoliosis. In this report, we present the case of a patient with segmental SSS and we briefly review the current literature about the topic.

Radiation-induced angiosarcoma of the breast: A review.

Angiosarcoma is a rare, aggressive malignant vascular neoplasm with poor prognosis that has a predilection for skin and superficial soft tissue. It can arise spontaneously or in association with factors like chronic lymphedema or radiation therapy. Radiotherapy used to treat invasive breast tumors is a known risk factor for the development of the so-called radiation-induced angiosarcoma (RIAS), a condition that has been described in the literature with increasing frequency. Radiation-induced angiosarcoma of the breast usually arises on the previously irradiated skin area several years after radiotherapy and presents as painless multifocal erythematous patches or plaques similar to a hematoma. Cutaneous biopsy is essential for the diagnosis. Histologically, RIAS is characterized by irregular anastomosing vessels lined by endothelial cells showing nuclear atypia. Treatment is mostly surgical, and mastectomy with negative margins is considered the standard procedure. However, recurrences are common, and an approach combining surgery, chemo- and radiotherapy may be more effective. The purpose of this study is to review the most recent medical literature on RIAS of the breast, with emphasis on its pathophysiology, clinical and histological features and current treatment options.

Primary cutaneous plasmacytosis: a case report.

Primary cutaneous and systemic plasmacytosis is a rare disorder characterized by infiltration of the skin by polyclonal plasma cells of unknown etiology, frequently accompanied by polyclonal hypergammaglobulinemia and diffuse superficial lymphadenopathy. It primarily arises in patients of Japanese descent, and it is exceedingly rare in Caucasians. We describe a 36-year-old Portuguese male who presented with disseminated reddish-brown plaques over the trunk, neck, and upper limbs with normal gammaglobulinemia consistent with a diagnosis of primary cutaneous plasmacytosis.

Generalised eruptive histiocytosis: Case report.

Generalised eruptive histiocytosis is a self-limited and benign non-Langerhans cell histiocytic disorder, characterised by recurrent crops of symmetrically distributed skin to red to brown coloured papules on the trunk and proximal extremities. Clinical and pathological correlation is required to establish the diagnosis. We herein present the clinical and histological features of generalised eruptive histiocytosis in a 24-year-old female patient.