[Basal-cell carcinoma of fingers: a rare location not to be ignored]. / Epithélioma basocellulaire des doigts: une localisation rare à ne pas ignorer.

The basal-cell carcinoma is the most frequent malignant tumor in human, usually involving the healthy sun-exposed skin of head and neck area, but thoracic and members localisations are possible. Macroscopic appearance is variable excepting the pathognomonic pearl. Periungual lesions are in this context very rare and we report the case of a 64-year-old man presenting with a basal-cell carcinoma on the thumb. A literature review was also performed and our purpose is to warn our colleagues about this quite often unrecognized pathology which may need a more aggressive treatment in case of delayed diagnosis, and to remind them that all chronic lesions impose a biopsy.

[The internal breast flap: a new technique of reconstruction]. / Le lambeau mammaire interne: une nouvelle technique de reconstruction.

AIM: The internal breast pedicle flap is not a well-known technique yet. Anyway, it is effective for some of breast reconstructions and partial thoracic defects. This technique is applied to patients presenting breast hypertrophy. In this article, we present the experience of our department in this technique, considering its indications, surgery details, complications that may occur and subsisting interrogations about this surgical approach. MATERIAL AND METHODS: Two patients were treated with internal breast pedicle flap, one for controlateral breast reconstruction and one for coverage of partial thoracic defect. RESULTS: Patients were followed; flap survival and aesthetic results were analyzed during consultations. Results were good and similar to other well-spread reconstruction techniques. CONCLUSION: The internal breast pedicle flap is a relevant, reproducible and easy technique. Overall results are satisfying and allow the possibility of applying other techniques in case of failure. You have to keep in mind the risk of making a transfer of a potentially carcinogenic tissue for a patient having already presented a breast cancer.

[Hereditary neuropathy with liability to pressure palsies (HNPP) in hand surgery: reminds and warn against a usually unrecognised disease]. / Les neuropathies tomaculaires et la chirurgie de la main : rappels et mise en garde sur une pathologie souvent méconnue.

Tomacula is a rare hereditary disease due to a deletion on chromosome 17. Clinical presentation varies but patients usually complain of recurrent paraesthesiaes and palsies related to compression or trauma of a peripheral nerve. Diagnosis is based on electrophysiological studies, nerve biopsies and genetic tests. Implications for the patient and family members are a genetic counselling and some simple preventive measures. Although there is no curative treatment for this neuropathy, surgery can be useful for decompression of nerves and neurolysis. However, the surgical act increases the risk of nerve damage. Knowing about the diagnosis can help the patient and the surgical team avoid causing lesions.

[The total thigh flap in reconstructive surgery]. / La place du lambeau total de cuisse en chirurgie reconstructrice.

Plastic surgeons have sometimes to face large pelvic tissue defects, particularly in paraplegic patients with recurrent pressure sores. This is frequently a reconstructive challenge and different locoregional flaps may be useful to manage those wounds when medical solutions were unsuccessful. However, in cases when other reconstructive options have been exhausted the total thigh flap represents the last acceptable solution to cover the defects by providing a large volume of healthy tissue. We remind here the operative technique and its interest in reconstructive surgery by reporting our experience in two patients for which this flap was successfully used.

Secondary localisation of an intra-thoracic benign mesenchymoma in the fossa poplitea: a rare paediatric case.

Thymomas are tumours that rarely occur in children, are almost invariably benign, and are usually discovered incidentally in the anterior mediastinum on chest X-rays. Whereas in adults these tumours are often associated with myasthenia gravis and other autoimmune diseases, this occurrence is very rare in the paediatric population. Multiple localisation and/or extra-thoracic recurrence of thymomas in children also appears to be exceptional with no reported cases in the English literature. We report one rare paediatric case.

[Total abdominal wall reconstruction. Management of full-thickness losses of the abdominal wall after a long ischemic compression]. / Reconstruction par greffe de peau d'un cas inhabituel de perte de substance étendue de la paroi abdominale secondaire à une compression ischémique prolongée.

The authors report an original case of a 70-year-old male with large musculocutaneous necrosis area of the abdominal wall following a long ischemic compression. Initial treatment was done using a wide excision of the abdominal wall necrosis and insertion of synthetic prosthesis to protect bowels. After 4 weeks of further surgical revisions, two splits thickness skin grafting were performed. The grafts were placed directly on granulations around and over the mesh and the healing was complete. Postoperative course was uneventful. In our experience, this technique allowed a good cicatrisation and a good esthetical result.