Venous wall graft in the eyelid reconstruction: observations drawn from 64 cases.

The aim of this report is to illustrate the venous wall graft and to present the observations drawn from a large series of eyelid reconstructions performed with this method. Sixty-four patients underwent venous wall grafts, mostly after resection of invasive carcinomas of the eyelids and, in only one case, after traumatic injury. All patients had good functional and cosmetic results. The average follow-up time was 6.5 years. Few negligible complications were observed. Only two cases (3.1%) needed further surgical treatment. Vein graft is a reliable alternative to traditional procedures in replacing tarsus-conjunctival layer, achieving satisfactory results. A single surgical session is required, usually without complications.

Understanding Barriers Impacting upon Patient Wellbeing: A Nationwide Italian Survey and Expert Opinion of Dermatologists Treating Patients with Moderate-to-Severe Psoriasis.

A nationwide cross-sectional online survey was administered to dermatologists managing patients with moderate-to-severe plaque psoriasis across Italy to obtain real-world dermatologists' perspectives on the impact of psoriasis and its treatment on patients' daily lives and quality of life (QoL). A total of 91 dermatologists (aged 39.1 ± 11.2 years) completed a 31-question survey and workshop sessions were undertaken in order to identify the best management approach to achieve patient wellbeing. Social (4.2 ± 0.1), physical (4.26 ± 0.2) and mental components (4.1 ± 0.3) were rated by dermatologists as contributing to patient wellbeing to similar extents. While a high proportion (85.4%; rating of 4.3 out of 5) of dermatologists felt that they considered the QoL of patients, a lower proportion (69.6%; rating of 3.7 out of 5) felt that patients were satisfied in this regard. The psoriasis area and severity index and body surface area were the instruments most frequently used to assess the physical domain, while interviews/questions and the dermatology life quality index were used to assess social and mental domains, with only 60% of dermatologists following up on these aspects. The importance of investigating the presence of comorbidities was recognized but not always carried out by many dermatologists, (>70%), particularly for obesity and anxiety/depression. This survey identified key components contributing to barriers impacting on the QoL of patients with moderate-to-severe psoriasis from the perspective of the dermatologist.

Sharing Patient and Clinician Experiences of Moderate-to-Severe Psoriasis: A Nationwide Italian Survey and Expert Opinion to Explore Barriers Impacting upon Patient Wellbeing.

A nationwide survey was conducted in adult patients with psoriasis (PsO) across Italy to obtain their real-world perspective of the impact of PsO on their wellbeing. Patients completed a 26-question survey (based on the patient benefit index; PBI, The Dermatology Life Quality Index; DLQI and the World Health Organization-five; WHO-5 wellbeing index) and workshop discussion sessions were undertaken by dermatologists to interpret results from the survey. 392 patients with PsO completed the survey. Analysis of results was restricted to patients who had moderate-to-severe plaque psoriasis (assessed by patients; n = 252; 64.3%). Dermatologists (n = 32) completed one question from the survey related to wellbeing and rated social, physical and mental domains as contributing to a similar extent, with comparable scores also observed by patients. For treatment, biologics yielded higher scores on average, whereas little difference was observed between topical and conventional systemic treatments. Only 23.8% of patients felt that their dermatologist was taking into consideration their wellbeing and 32.6% of the patients considered their therapy as inadequate in improving signs and symptoms of the disease. This survey identified key factors contributing to barriers impacting on patient wellbeing. Simple, but comprehensive questionnaires can provide important insight to patients' needs that may significantly increase clinician awareness during visits leading to tailored treatment.

Reconstruction of the tarsus-conjunctival layer using a venous wall graft.

PURPOSE: The repair of full-thickness defects of the eyelids poses a challenge, because the reconstruction of the tarsus-conjunctival layer often results in aesthetically and functionally unsatisfactory outcomes. The authors' aim was to create a new method to repair large tarsus-conjunctival losses and to examine the outcomes of its use. METHODS: Seven patients with invasive carcinoma of the eyelids underwent a venous wall graft. RESULTS: All patients had good to outstanding results and no complications. CONCLUSION: This new reconstruction of the deeper layer of the eyelid provides a useful alternative to traditional methods (composite grafts and full-thickness flaps). Our new surgical technique is easy to execute and has good functional and aesthetic results.