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Wound healing is a multifaceted process. Restoration of the epithelium may occur either by migration of activated epithelial keratinocytes from the adjoining epithelium or by centrifugal migration of putative stem cells found in the bulge region of the hair follicle. Dermal collagen and glycosaminoglycans also play a key role in laying down the scaffold for vascular in-growth and population of the matrix with host fibroblasts. Despite the availability of a wide range of treatment modalities, chronic nonhealing leg ulcers remain a therapeutic challenge and cause significant patient morbidity. Hence, there is a further need to develop novel techniques which would be effective, safe, easily available, and affordable for the patient.
RESUMO
Rhinophyma is characterized by nodular thickening of the Nasal skin, sebaceous gland hyperplasia, dilated pores, and in its late stage, fibrosis. In severe cases, it results in loss of normal facial contours, significant disfigurement, and social isolation. Treatment options for severe rhinophyma include cryosurgery, partial-thickness decortications with subsequent secondary reepithelialisation, laser ablation, full thickness resection with graft or flap reconstruction, excision by electrocautery or radio frequency. We report a case of severe rhinophyma resulting in marked facial disfigurement treated successfully with trimodal therapy with excellent cosmetic outcome on a long term follow up.
RESUMO
BACKGROUND: Non-healing trophic ulcers in Hansen's disease patients is one of the major causes for disability. It has been shown that autologous platelet-rich fibrin matrix (PRFM) is effective in healing chronic non-healing leg ulcers. AIM: The objective of this study is to demonstrate the efficacy of autologous platelet-rich fibrin matrix (PRFM) in non-healing trophic ulcers in patients treated for Hansen's disease. DESIGN: A prospective study. SETTING: An institution-based clinic. PARTICIPANTS: Seven treated patients with Hansen's disease, with a mean age of 38.33 years, with nine non-healing trophic ulcer of more than 6 weeks duration. MEASUREMENTS: Photographs were taken before treatment and at every subsequent sitting. Area and volume were calculated at baseline and every subsequent sitting till the closure was achieved. MATERIALS AND METHODS: The healthy ulcers were treated with PRFM at weekly intervals, repeated once a week for a maximum of five sittings as per requirement. RESULTS: The mean percentage improvement in the area was 93.52%, and volume was 97.74% at the end of the second sitting. All ulcers closed by a maximum of five sittings. No adverse events were noted. CONCLUSION: PRFM for the treatment of trophic ulcers in treated patients with Hansen's disease is a feasible, safe, simple and inexpensive method.
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Conventional technique of dermal grafting for acne scars where the source of filler material used is the patient's own dermis requires longer surgical time, recovery period and can result in unsightly scars at the donor area. Hence, it is not suitable for treating a larger number of scars. Furthermore, these dermal grafts are firm and cannot be contoured to fit all types of acne scars. Occurrence of epidermal cyst and secondary infection is another complication if epidermis is not completely removed. Enzymatic techniques need trypsinisation which is expensive and requires laboratory facilities.
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Cutaneous metastasis in a zosteriform pattern is a very rare entity being reported only in 63 patients worldwide. Cutaneous metastases usually presents late in the course of the disease or sometimes after the treatment of the primary when it indicates recurrence of a treated malignancy. We report a case of zosteriform cutaneous metastases masquerading as lymphangioma without prior presentation of the primary malignancy.