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INTRODUCTION: Hidradenitis suppurativa (HS) is a chronic inflammatory disorder with distinct characteristics: chronic nature, morphology, and location. It originates from occluded and ruptured follicles, releasing keratin and bacteria into the nearby dermis. This causes an inflammatory reaction, leading to the formation of abscesses and the destruction of the pilosebaceous junction. CASE PRESENTATION: We present the case 24-year-old female with a severe, stage III case of HS who had a lesion (approx. 10 × 15 cm) on her right axilla spanning 4 years. Despite some response to medical treatment, she experienced recurrent symptoms, due to this, surgical intervention was decided, using a latissimus dorsi thoracodorsal artery perforator (TDAP) flap. The lesion was successfully removed, and the flap was placed, leading to proper postoperative healing, cicatrization, and sensitivity in the patient. DISCUSSION: HS poses a challenge due to its recurring course. Treatment involves pharmacological and surgical approaches, with the former suited for mild to moderate cases and the latter for severe instances. Surgical options, like TDAP flaps, show lower recurrence rates than skin grafts. TDAP flaps also offer advantages such as reduced bulkiness and favorable aesthetic and functional outcomes compared to other latissimus dorsi flaps. CONCLUSION: HS represents an obstacle in terms of systemic effects and aesthetic concerns. Lattisimus dorsi flaps have emerged as an effective treatment method due to the reliable vascular supply and adequate volume to the recipient site as demonstrated by our case, where the patient showed appropriate evolution with no morbidity associated with the procedure as well as adequate aesthetic results.
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INTRODUCTION: Retroperitoneal Liposarcomas (RL) are a rare form of malignant tumors, they encompass just 5 % ot these and mainly present in female adults between 50 and 60 years of age. They can be divided into 4 morphological subtypes: 1) well-differentiated, 2) undifferentiated, 3) myxoid, and 4) pleomorphic. CASE PRESENTATION: 41-year-old male who present to the outpatient consult of oncological surgery after being diagnosed via imaging with a giant retroperitoneal liposarcoma. The patient reported unsuccessful weight loss attempts and subsequently noticed an increase in abdominal size as well as the development of ulcers in the lower limbs. He underwent radical resection, which included a right nephrectomy, as the primary treatment. DISCUSSION: Giant retroperitoneal liposarcomas are defined as those 30 cm in diameter or more or 20 kg or more in weight are considered "giants" and are extremely rare. The only treatment involves resection of the tumoration and those adjacent involved organs, and sometimes, uninvolved ones. Due to the high risk of recurrence, adjuvant therapy may be provided as well as imaging follow up. CONCLUSION: RL are a complicated entity to manage. They tend to present high rates of recurrence due to the difficulty of performing a full resection without positive margins. These patients should be thoroughly studied before surgery and appropriate follow-up should be provided.
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BACKGROUND: Weight loss in Parkinson's disease (PD) patients is a common but poorly understood manifestation. Several studies have reported that weight changes could be related to motor symptoms, drug side effects, dysphagia, depression, and/or dementia. Weight loss in PD is not a benign phenomenon and it has several clinical and prognostic implications with increased morbidity and mortality. Thus, it is crucial to determine nutritional changes in PD patients in order to prevent malnutrition and improve their quality of life. OBJECTIVE: To compare body composition and resting metabolic rates between PD patients and controls. METHODS: A total of 64 PD patients and 52 controls were studied. The Hoehn-Yahr scale was used to determine the disease stage, clinical and epidemiological data were recorded from verbal questionnaire, Inbody S10® was used to collect corporal parameters, and FitMate system was used to assess the resting metabolic rate. RESULTS: No significant differences were found between both experimental groups in age, gender, height, cholesterol levels, and the presence of hypertension, diabetes, and hypo/hyperthyroidism. However, the PD group showed lower body fat mass, whole-body fat percentage, and greater resting metabolic rate compared to controls (p < 0.05), with no significant differences in musculoskeletal mass. Parkinson's disease postural instability/gait difficulty (PD-PIGD) subtype showed lower body fat parameters, increased fat-free mass, and higher resting metabolic rates. CONCLUSIONS: These results suggest that PD patients present an increased resting metabolic rate associated with the postural instability/gait difficulty PD subtype, allowing a selective decrease of body fat mass and not musculoskeletal mass. Of note, several disease-related factors may contribute to this weight loss in PD patients, being a complex and multifactorial consequence. Our findings could likely be one of the many contributing factors. However, present findings may further add to our understanding of the phenomenon of weight loss in patients with PD.
