The use of infrared radiation in the treatment of skin laxity.

BACKGROUND: Cosmetic surgery and medicine are extremely interesting fields for a plastic surgeon. Lasers and lights determine ablation, contraction and regenerating stimulus in skin tissues. The aim of this study is to examine the use of infrared lights in treating facial and body skin laxity. METHODS: Between 2007 and 2011, in the Department of Plastic and Reconstructive Surgery at the Hospital San Camillo-Forlanini, 303 patients were enrolled in the study and underwent laser therapy. The laser operates in wavelength from 1100 to 1800 nm. The treated areas are: face, neck, eyebrows, abdomen, legs and buttocks. RESULTS: We have noticed no systemic complications. A case of a patient with a three days lasting erythema on both lower eyelids caused by laser therapy healed without any pharmacological therapy. Neither hyper- nor hypopigmentation of the skin was found. The satisfaction degree of patients has been: facial, neck and eyebrow lifting "very satisfactory" for 70% of the patients, "satisfactory" for 10%, "unsatisfactory" for 20%; for the other areas it was "very satisfactory" for 40%, "satisfactory" for 20% and "unsatisfactory" for 40%. CONCLUSION: The use of infrared radiation represents a valid alternative to surgical lifting, but cannot replace it. The infrared light technique used has turned out to be useful in contrasting skin laxity of the face and other parts of the body. The absence of scars and surgical risk makes this technique useable for a large number of patients.

Syndromic true hermaphroditism due to an R-spondin1 (RSPO1) homozygous mutation.

XX true hermaphroditism, also know as ovotesticular disorder of sexual development (DSD), is a disorder of gonadal development characterized by the presence of both ovarian and testicular tissue in a 46,XX individual. The genetic basis for XX true hermaphroditism and sex reversal syndromes unrelated to SRY translocation is still mostly unclear. We report mutational analysis of the RSPO1 gene in a 46,XX woman with true hermaphroditism, palmoplantar keratoderma, congenital bilateral corneal opacities, onychodystrophy, and hearing impairment. R-spondin1 is a member of the R-spondin protein family and its pivotal role in sex determination has been recently described. We identified a homozygous splice-donor-site mutation in the RSPO1 gene in our patient. We found that the c.286+1G>A mutation led to an aberrantly spliced mRNA (r.95_286del), which is presumably translated into a partially functional protein (p.Ile32_Ile95del). Our case demonstrates for the first time, to our knowledge, that XX true hermaphroditism can be caused by a single gene mutation. The reported findings represent a further step toward a complete understanding of the complex mechanisms leading to DSDs.

Giant non Hodgkin lymphoma of Scarpa's triangle: a case report.

A 72-year-old lady was admitted to hospital with a large, bleeding mass on the right groin and an 8-month history of deep vein thrombosis of the left leg with pulmonary microembolisation treated medically. On clinical examination there was a solid, necrotising and bleeding right inguinal mass which extended 20 cm below the right inguinal ligament. A tissue biopsy, performed under local anaesthesia, revealed the presence of a non Hodgkin lymphoma with giant B-cells of follicular origin. An angio-CT scan of the pelvis and of the leg showed the compression of the 30 cm diameter tumour on the surrounding tissues. The mass appeared to be extra-compartmental and to have a non-homogeneous aspect with internal areas of necrosis and colliquation. Particular attention was devoted to the femoral vessels which were apparently not involved in the tumour mass. The patient was then operated on by a team of vascular and plastic-reconstructive surgeons. She underwent an operation consisting in an inguinal mass excision and skeletisation of the femoral vessels and nerve. The wound was then closed using both an abdominal and lateral flap from the hip. Postoperatively the patient made an uneventful recovery and was discharged from hospital on postoperative day 11. Follow-up at 3 months showed good healing of the wound and no signs of metastatic spread of the tumour.