[A case of penile metastasis of malignant melanoma with priapism].

A metastatic penile tumor of malignant melanoma is very rare. The patient had priapism caused by metastatic penile tumor and the primary cancer was in the end stage. However, in this case, we could relieve the dysuria and pain by percutaneous cystostomy and partial penectomy. The corpus spongiosumcorpus cavernosum shunt could not relieve the priapism and might have accelerated the metastasis.

Arthroplasty of the interphalangeal joint of the great toe using costal osteochondral grafting.

Although many reports have been published on the usefulness of costal cartilage grafting in the reconstruction of interphalangeal joints of fingers, there are only a few published reports on the reconstruction of interphalangeal joints of toes. We describe a 21-year-old woman with a tissue defect of the dorsum pedis and a partial defect of the interphalangeal joint of the great toe caused by a motor-vehicle accident. We attempted arthroplasty using a free latissimus dorsi myocutaneous flap and a costal osteochondral graft. The grafted rib and cartilage survived, allowing the patient to resume functional ambulation for day-to-day activities. Arthroplasty using costal osteochondral grafts seems to be an effective means of reconstructing the interphalangeal joints of toes.

Treatment of osmidrosis with the Cavitron ultrasonic surgical aspirator.

BACKGROUND: Axillary osmidrosis is an uncomfortable condition that can be a personal or social handicap. OBJECTIVE: The objective was to present the treatment of osmidrosis with the Cavitron ultrasonic surgical aspirator (CUSA). MATERIALS AND METHODS: Fifteen patients (3 males and 12 females) underwent surgery for bilateral axillary osmidrosis with the CUSA. RESULTS: The outcome of this operation with the CUSA was evaluated by the patients themselves according to the following criteria. Postoperative improvement was evaluated as good when the odor was decreased by >75%, fair when it was decreased by > or =50 and < or =75%, and poor when it was decreased by <50%. A total of 15 patients (3 males and 12 females) were evaluated. Eight patients (53.3%) had a good result, 6 patients (40%) had a fairly good result, and 1 patient (6.7%) had a poor result. None of the patients experienced any complications, such as skin necrosis, infection, or serous cyst. One dissatisfied patient underwent reoperation and achieved a good result after the second procedure. CONCLUSIONS: This treatment of osmidrosis with the CUSA achieves satisfactory therapeutic efficacy.

Clear-cell hidradenoma of the forearm in a young boy.

We treated a 5-year-old boy with clear-cell hidradenoma of the forearm. Our literature search found only one previous report of this disease occurring during the first decade of life, and the present patient is the first with involvement of the limbs. This presentation demonstrates that clear-cell hidradenoma needs to be considered in the differential diagnosis of cutaneous tumors even in young children, which is of interest because malignant transformation can occur.

Partial matricectomy with a CO2 laser for ingrown toenail after nail matrix staining.

BACKGROUND: Ingrown toenail is a common nail disease that causes pain, discomfort, and difficulty in walking. It is treated with either conservative therapy or surgery. OBJECTIVE: To present a new surgical approach to ingrown toenail. MATERIALS AND METHODS: For 19 ingrown toenail borders of 14 toes in 14 patients (1 male and 13 females), the nail matrix was stained with methylene blue and then partial matricectomy was performed with a CO2 laser. RESULTS: There was no recurrence at 18 nail borders after a mean follow-up period of 13.4 months, whereas a spike grew at one border but caused no walking pain. No serious complications occurred. Cosmetic improvement was also satisfactory. CONCLUSIONS: Partial nail matricectomy with a CO2 laser after staining the nail matrix with methylene blue allows visual confirmation of the completeness of cauterization.

Eyebrow reconstruction with intermediate hair from the hairline of the forehead on the pedicled temporoparietal fascial flap.

Although various reconstructive procedures for the eyebrow have been reported, few have proved satisfactory for large-tissue defects. The authors describe two cases of eyebrow reconstruction with intermediate hair from the hairline of the forehead on the pedicled temporoparietal fascial flap (TPF flap) after malignant tumor resection. The first patient was a 24-year-old man with an adnexal carcinoma of the left eyebrow. An intermediate hair flap was prepared at the hairline of the forehead in accordance with the defect. The second patient was a 48-year-old woman with Bowen's disease of the left eyebrow. Tumor resection was performed on the frontal muscle with a 5-mm surgical margin. An intermediate hair flap was prepared at the hairline of the forehead in accordance with the defect. Both reconstructed eyebrows have maintained their shapes well. There have been several reports of the use of a TPF flap for eyebrow reconstruction, but none have used intermediate hair from the hairline. The authors are convinced that use of intermediate hair from the hairline of the forehead on the pedicled TPF flap is effective for reconstruction of the eyebrow and large defects extending to nonhairy subbrow skin.