Congenital isolated juvenile xanthogranuloma of the sole - a unique case report in a newborn.

Juvenile xanthogranuloma (JXG) is a rare, benign non-Langerhans cell histiocytosis that primarily affects the skin, with infrequent extracutaneous manifestations. Lesions typically emerge during early childhood and often resolve spontaneously, obviating the need for treatment. This paper details the case of a child diagnosed with a solitary JXG on the sole, necessitating surgical excision due to its functional impairment, specifically a delay in walking and weight bearing.

[Headphone Explosion Burn]. / BrÛlure Par Explosion De Casque Audio.

The explosion of headphones is a rare incident, not reported in the literature, and is responsible for serious burns involving functional and aesthetic consequences with a major psychological impact. We report here the case of a young boy in order to raise awareness in the population and draw attention to these risks.

[What surgery for recurrent Darier-Ferrand sarcoma of the chest wall?] / Quelle chirurgie pour la forme récidivante du sarcome de Darrier-Ferrand de la paroi thoracique ?

INTRODUCTION: Dermatofibrosarcoma protuberans (Darrier-Ferrand sarcoma, DFSP) is an uncommon tumor. This sarcoma has a tendency to local recurrence, requiring a wide surgical resection. OBSERVATION: We report herein two cases of patients presenting with recurrent dermatofibrosarcoma protuberans after several surgical resections. A wide surgical resection with guided tissue regenaration has been performed in one case, whereas the second case required a skin graft. CONCLUSION: Despite a short follow-up, our aim was to highlight the local aggressiveness of the DFSP and point out its therapeutic challenge, usually requiring a wide and aggressive surgery.

[Management of eyelid carcinomas: Retrospective bicentric study of 64 cases and review of the literature]. / Prise en charge des carcinomes des paupières : étude bicentrique rétrospective sur 64 cas avec revue de littérature.

PURPOSE: To study the epidemiologic, clinical and histological aspects of eyelid carcinomas in our context, and to evaluate our surgical management on an oncological, functional and aesthetic level. PATIENTS AND METHODS: This work is a retrospective bicentric study extended over a 5-year period between January 2009 and December 2013, including 64 patients with eyelid carcinoma undergoing surgery in the Plastic and Reconstructive Surgery Department at the Avicenne University Hospital of Rabat and in the ENT/Head and Neck Surgery Department at the Hassan II University Hospital of Fez. RESULTS: The study included 25 men and 39 women with a mean age of 60.6 ± 15.33 years. Advanced age and chronic sun exposure were the most important risk factors. The most commonly involved site was the lower eyelid (53%). Histological examination emphasized the very high prevalence of basal cell carcinoma (90.62%). Surgical treatment was performed in all our patients followed by an extemporaneous and/or standard histological examination of the surgical specimen. Exenteration was performed in one patient with adjuvant radiation therapy. Reconstruction incorporated a variety of techniques, of which total skin graft and Mustardé flap were the most common in our series. Aside from a few complications, the postoperative results were satisfactory for the majority of our patients. CONCLUSION: Malignant tumors of the eyelids, of which basal cell carcinoma is the most common, pose a therapeutic problem where surgery remains the most utilized treatment option. The best treatment is prevention and diagnosis of early lesions to improve prognosis and to avoid worse outcomes.

Paenibacillus larvae Phage Tripp Genome Has 378-Base-Pair Terminal Repeats.

Paenibacillus larvae bacteriophage Tripp was isolated from an American foulbrood diseased honey bee hive in North Carolina, USA. The 54,439-bp genome is 48.3% G+C, encodes 92 proteins, no tRNAs, and has 378-bp direct terminal repeats. It is currently unique in Genbank.

[Comments on article "Scalp flap pedicled on posterior auricular artery. Anatomical study and clinical application"]. / Commentaires de l'article "Lambeau de scalp pédiculé sur l'artère auriculaire postérieure. Étude anatomique et application clinique".

The authors comment on the reliability of the scalp flap pedicled on auricular posterior artery, arguing with the conclusions of anatomic studies published in this issue and their little experience in reconstructing scalp defects by local flaps.

[Trichoblastic carcinoma]. / Un carcinome trichoblastique.

INTRODUCTION: Trichoblastic carcinoma is a rare malignant adnexal tumor. Its presentation is non-specific and the diagnosis is always histological. CASE REPORT: A 56-year-old patient presented with a trichoblastic carcinoma of the eyelid and eyebrow. It was located on the lower end of the scar, 7 years after the incomplete excision of a tumor. There was a large subcutaneous extension of the tumor, well beyond the visible margins of the skin lesion. The treatment was a broad surgical excision followed by radiotherapy. There was neither local recurrence nor metastasis 20 months later. DISCUSSION: This clinical presentation was atypical and had never been reported. We discuss the therapeutic management of this rare tumor.

[Role of the aponeurotic variation of the posterior interosseous flap in the treatment of burns sequelae on the dorsum of the hand]. / Place du Lambeau Interosseux Posterieur dans sa Variante Aponevrotique dans le Traitement des Sequelles de Brulure de la Face Dorsale de la Main.

Le lambeau interosseux postérieur dans sa variante aponévrotique est un outil très intéressant dans le traitement des séquelles de brûlures de la face dorsale de la main. Les Auteurs cherchent, à travers un cas clinique et une revue de la littérature, à replacer cette variante dans l'arsenal thérapeutique.

Reconstruction of cheek skin defects by the 'Yin-Yang' rotation of the Mustardé flap and the temporoparietal scalp.

BACKGROUND AND PURPOSES: When the skin's laxity is limited, the preauricular cutaneous defect resulting from the Mustardé cheek rotation flap for the coverage of suborbital skin defects is very difficult to close even with a large undermining of the cervicofacial skin. The rotation of the temporoparietal scalp in an opposite direction compared to the Mustardé flap or the 'Yin-Yang' rotation of these flaps is interesting for two reasons: it allows an easy closure of this preauricular defect with a limited facial undermining and it suspends with efficiency the Mustardé flap at the temporal area avoiding the lower lid's ectropion. MATERIAL AND METHODS: From September 2001 to April 2005, nine patients aged between 35 and 78 years old, with no facial skin laxity, have benefited from this technique to cover suborbital defects secondary to excision of basal cell carcinomas with a mean diameter of 6 cm. The design of the Mustardé flap was classical but the skin undermining stopped at the mandible's lower border. The triangular preauricular defect has served as a geometrical base to design an opposite temporoparietal rotation flap which is undermined under the galea. RESULTS: This technique has allowed an easy primary closure of all these defects. No complications were reported. With a mean follow up of 36 months the aesthetic quality of these reconstructions was satisfying and there was no malposition of the lower lid. CONCLUSION: This is a good technique for the simple coverage of medium-sized suborbital skin defects.

[Not Available]. / Brulures par Bouillottes Chez les Diabetiques.

Diabetic neuropathy is a frequent complication of diabetes. The most frequent clinical form is known as "sock polyneuritis", with loss of sensitivity to pain in the feet. Hot water bottle burns are the prerogative of diabetic patients suffering from a form of sensitive polyneuropathy. Such burns are deep. It is difficult to take therapeutic responsibility and decisions must be multidisciplinary. We underline the importance of the education of diabetic patients and of arousing their awareness to the possible risks involved in the use of hot water bottles.

[Local flaps in the treatment of full thickness scalp defects secondary to advanced cutaneous malignancy. About 21 clinical cases]. / Lambeaux locaux pour pertes de substance transfixiantes du scalp sur tumeurs évoluées. A propos d'une série de 21 patients.

SUBJECT: The advanced tumors of the scalp can involve the calvarium, the dura and the cerebral tissue. The medium sized full thickness scalp defects secondary to the excision of such cutaneous malignancy can be successfully treated with local flaps coming from the remaining scalp if these flaps are large and including at least one major pedicle of the scalp. The cranioplasty can be done immediately or secondarily. PATIENTS AND METHODS: From May 2001 to July 2006, 21 patients aged between 52 and 78 years old, suffering from advanced basal and squamous cell carcinomas with invasion of the calvarium in all cases, the dura in 1 case and the cerebral tissue in 2 cases have benefited from an excision of the scalp and calvarium with a margin between 1 and 3 cm. The secondary defects measured between 9 and 15 cm for the scalp and between 6 and 9 cm for the calvarium. In 1 case, the dura was resected and reconstructed with a fascia lata graft. The flaps used were: a single pedicled transposition flap based on one or two occipital pedicles in 10 cases--a bipedicled transposition flap based on the superficial temporal pedicles in 3 cases and on the frontal and occipital pedicles in 4 cases--a large rotation flap in 4 cases. These flaps were undermined under the galea without any galeotomies. Their donor sites were immediately grafted. The calvarium was reconstructed by a methylmetacrylate implant in 9 cases, simultaneously with these flaps in 4 cases and secondarily in 5 cases. RESULTS: There were no vascular problems in all these flaps--3 cases of infection in the simultaneous reconstruction of the scalp and calvarium are reported. The two patients with cerebral invasion are deceased 1 year after the surgery. The other patients are still alive without any recurrence or metastasis with a mean follow-up of 36 months. CONCLUSION: Such complex defects of the tumoral scalp can be reconstructed with large and axial local flaps of the remaining scalp with safety. The cranioplasty has to be delayed.

[A simple way to secure the distally based fascio-cutaneous flap of the leg: the lesser sapheneous-greater sapheneous vein anastomosis. Report of 15 clinical cases]. / Sécurisation des lambeaux fasciocutanés de jambe à pédicule distal par l'anastomose saphène externe-saphène interne. A propos de 15 cas cliniques.

PURPOSE: The distally based fasciocutaneous flaps of the leg are very useful for the treatment of skin defects at the lower third of the leg and the foot, but the venous congestion due to the reverse flow can be responsible of necrosis at the distal part of the flap. The anastomosis of the lesser saphenous vein which is included in the flap's dissection to the greater saphenous vein near the defect avoid this venous congestion and the necrosis of the most useful part of the flap for the coverage of these defects. MATERIAL AND METHODS: From January 1999 to June 2005, 15 patients aged between 22 and 64 years old have benefited for the treatment of soft tissue defects secondary to trauma with a mean diameter of 7 x 10 cm and located in 7 cases at the lower third of the leg and in 8 cases at the posterior side of the heel, from distally based posterior fasciocutaneous flaps where the venous reverse flow has been changed in a physiological one by the terminolateral anastomosis between the lesser and greater saphenous vein. The dissection of these flaps was classical except that the lesser saphenous vein was dissected 6 cm beyond the proximal part of the flap in the popliteal region. RESULTS: In all these flaps, there was no venous congestion and no arterial problems. With a mean follow-up of 40 months, the coverage's quality of these defects was very satisfactory. No sequellae are reported. CONCLUSION: The anastomosis between the lesser and the greater saphenous veins seems to eliminate the main source of failure of the distally based fasciocutaneous flap of the leg and can reinforce the indications of these flaps for the treatment of such defects.

[The fasciomusculocutaneous flap at the leg. About 9 clinical cases]. / Le lambeau fasciomusculocutané de jambe. A propos de 9 cas cliniques.

The fasciomusculocutaneous flap at the leg (FMC) include a muscle strip in the classic dissection of the fasciocutaneous flap (FC); this muscle survives only by the musculocutaneous vessels perforators. This muscle improves the trophic quality of the classic FC flap and allows him to bring easily muscle to the lower third of the leg and sole of the foot. From october 96 to january 2001, 9 posterior FMC flaps have been used in 9 men, their ages were between 22 and 61-years-old, 8 of these flaps were distally based and 1 was proximally based. The muscle strip came from the medial gastrocnemius muscle, its lengh and its width corresponded to the dimension of this muscle but the depth has never exceeded 10-12 mm. The skin defects have a diameter ranging from 7 to 10 cm and were localised in 3 cases in the sole of the foot, in 5 cases in the lower third of the leg with 1 case of tibial osteomyelitis and in 1 case in the external part of the knee. All these defects were secondary to trauma. No complications were reported with this technique. There was no vascular problems with the muscle strip: its bleeding was checked at the operating room and at 3 weeks when the pedicle was severed. All these patients were hospitalized between 4 and 5 weeks. With an average of 30 months follow-up all the defects covered were very satisfying and the case of the osteomyelitis was healed. There is no functional sequellae and the aesthetic sequellae are those of the classic FC flaps at the leg.

[Is a dynamic or stable technique needed for metacarpophalangeal joints of the hand in ulnar nerve palsy?]. / Faut-il réanimer ou juste stabiliser les métacarpophalangiennes des doigts et du pouce des mains cubitales?

INTRODUCTION: It seems interesting to choose between the dynamic and the static techniques for the rehabilitation of the hand suffering from an ulnar nerve palsy on the basis of the grasp (F1) and pinch (F2) strengths which are important in this rehabilitation. METHODS: From june 1997 to december 2001, 30 ulnar palsies all post traumatic with non complicated claw deformities have been collected and distributed in three groups of ten patients. In the group A only the static techniques have been used on the MP joints of the fourth and fifth digits and the thumb; in the group B only the dynamic techniques have been used on the fourth and fifth digits, on the flexor pollicis brevis and on the first dorsal interosseous muscle; in the group C, the MP joint of the thumb has been stabilized and dynamic techniques have been used on these two muscles, the MP joints of the fourth and fifth digits have been only stabilized. The techniques used in this study were among the most popular. The grasp and pinch strengths were measured by a mechanical dynamometer at the preoperative period and at third and sixth postoperative month. RESULTS: At sixth month, in the group A, F1 didn't change and F2 has increased by 9%; in the group B, F1 has decreased by 24% without recovery of the preoperative value and F2 has increased by 13%; in the group C, F2 has increased by 19%. DISCUSSION: For a reconstruction of an useful hand in an ulnar nerve palsy, the best solutions seem: for the fourth and fifth digits: simple stabilization of the MP joints for the thumb: an association of this stabilization and a rehabilitation of some muscles involved in the pinch prehension.