Aplasia cutis congenita type V: a case report and review of the literature.

Aplasia cutis congenita (ACC) is a relatively rare congenital anomaly that most commonly occurs as a solitary cutaneous defect on the scalp. Depth of involvement varies, and involvement of deeper calvarium and dural structures can be seen in more severe cases. Multiple classification systems have been devised with the Frieden Classification System being the most widely adopted. Using this system, we describe a patient that developed Type V ACC with associated fetal papyraceous. The child healed remarkably well with the application of petrolatum impregnated gauze and topical silver sulfadiazine twice daily for approximately 4 weeks. The child was noted to have no significant contractures or complications at 6-months and 1-year follow-up exams. Herein, we review the current literature on type V ACC including a discussion of treatment options.

Mechanical properties of commercially available nylon sutures in the United States.

Surgeons can choose from a wide selection of commercially available suture brands, which come at a range of prices. There is currently limited evidence in the literature to guide this selection process. This investigation examined the breaking force, stress, and elongation of a variety of commercially available nylon sutures compared to their relative prices. Seven 5-0, nonabsorbable, nylon suture brands were tensile tested in straight, knotted and knot-security configurations according to the procedures outlined by the United States Pharmacopeia for the tensile testing of sutures. Covidien, the cheapest brand tested, had the highest failure load of straight and knot-security tests. Dafilon was found to have the highest breaking force and percent elongation of knot-pull tests. J&J Ethicon and Supramid had the highest percent elongation to failure for straight-pull and knot-security tests, respectively. This study was limited to specific in vitro tensile properties of nylon suture. Other factors affecting suture quality and price, such as needle properties, were not investigated. The data presented in the study provide information for guiding the selection and purchase of sutures according to tensile properties. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 815-819, 2017.

Mechanical properties of suture materials in general and cutaneous surgery.

Comprehensive studies comparing tensile properties of sutures are over 25 years old and do not include recent advances in suture materials. Accordingly, the objective of this article is to investigate the tensile properties of commonly used sutures in cutaneous surgery. Thirteen 3-0 sized modern sutures (four nonabsorbable and nine absorbable) were tensile tested in both straight and knotted configurations according to the procedures outlined by the United States Pharmacopeia. Glycomer 631 was found to have the highest failure load (56.1 N) of unknotted absorbable sutures, while polyglyconate (34.2 N) and glycomer 631 (34.3 N) had the highest failure loads of knotted absorbable sutures. Nylon (30.9 N) and polypropylene (18.9 N) had the greatest failure loads of straight and knotted nonabsorbable sutures, respectively. Polydioxane was found to have the most elongation prior to breakage (144%) of absorbable sutures. Silk (8701 MPa) and rapid polyglactin 910 (9320 MPa) had the highest initial modulus of nonabsorbable and absorbable sutures, respectively. The new data presented in the study provide important information for guiding the selection of suture materials for specific surgeries.

Leukemia cutis coexisting with dermatofibroma as the initial presentation of B-cell chronic lymphocytic leukemia/small lymphocytic lymphoma.

: Cutaneous involvement by chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is often observed in patients with a known history of systemic disease. Rarely, CLL/SLL may initially present with skin lesions. There are also rare reports of cutaneous CLL/SLL occurring in herpes scars and as an incidental finding in excision specimens for carcinoma. We present a 76-year-old woman with an inverted conical firm papule on the upper back that was clinically suggestive of a dermatofibroma. Excisional biopsy demonstrated the presence of a dermatofibroma coexisting with CLL/SLL. We describe the rare occurrence of CLL/SLL initially presenting as leukemia cutis. In addition, to the best of our knowledge, this is the first report of dermatofibroma coexisting with CLL/SLL. This finding further expands the types of skin lesions that may coincide with CLL/SLL.

Acute angioedema response to topical 5-fluorouracil therapy.

This is a case report involving a patient who was treated with topical 5-FU cream and subsequently developed a severe case of angioedema. This case presents the possibility of anaphylaxis to topical 5-FU treatments and/or the interaction with angiotensin converting enzyme inhibitors. To our knowledge there has been no prior reported case of this reaction. We present this unusual case along with a review of the current literature on angioedema.