Aesthetic aspects of reconstructive surgery of the lower lid.

Aesthetic repair of the lower eyelid should use palpebral skin and restrict the cutaneous scars to the orbital area. Except in young patients or those having previously undergone a blepharoplasty, it is usually possible to raise a 10- or 12-mm-wide flap from the upper eyelid. The use of such a flap lined with an alar chondromucosal graft is advocated in a one-stage procedure. This graft ensures a good functional result and the stability of the new eyelid because the cartilage is as high in its bulk as the lid. In spite of histologic differences, where the tarsus is not a cartilage and the inner lining of the ala nasi is not actually a mucosa, the alar chondromucosal graft is very much like the tarsoconjunctival complex. When the alar defect is accurately repaired, no deformation of the nose results.

[Peyronie's disease. Hemodynamic and morphological conditions and treatment. Apropos of 14 cases]. / La maladie de la Peyronie. Conditions hémodynamiques, morphologiques et traitement. A propos de quatorze cas.

A study of fourteen cases of Peyronie's disease with an evaluation of the hemodynamics of the erectile function shows that erectile dysfunction, as a complication, is mainly due to abnormal venous drainage from the corpora cavernosa. This article discusses the therapeutical conclusions to be drawn, in the light of the results of seven operations.

[Stage I malignant melanoma of the skin. Prognostic value of thickness and level (author's transl)]. / Mélanomes malins de stade I. Importance pronostique de l'épaisseur et du niveau.

In a retrospective study of 95 patients seen between 1950 and 1978, the outcome of malignant melanoma levels III, IV and V of Clark's classification was reviewed. Patients with lentigo malignant melanoma were excluded. The overall survival rate was 63% at 5 years and 48% at 10 years. For the whole population of patients significant differences in survival rate were associated with level (p = 0,00002), thickness (less than 2 mm or greater than or equal to 2 mm; p less than 0.0,0001) and histological type (p = 0,02). The significance of prognostic variables taken separately was calculated by the Breslow method and was found to be: p = 0,0005 for thickness, p = 0,0009 for patient's age and p = 0,02 for histological type. In analysis with two variables, including level, thickness was the variable that added most to the information on prognosis supplied by level. For the population of patients with melanoma levels III and IV significant differences in survival rate were associated with thickness (less than 2 mm or greater than or equal to 2 mm; p less than 0,001), though not with level. When the variables were studied separately, thickness and patient's age were significant (p = 0,02 and p = 0,03 respectively). Analysis with two variables, including thickness, showed that age was the variable that added most to the information on prognosis supplied by thickness.

[Anular centrifugal erythema on the site of injection of hormone preparation in oil suspension]. / Eritema anular centrífugo en los puntos dy inyección de preparados hormonales en suspensión oleosa

An erythema annulare-like lesion following the intramuscular injection of a suspension of estrogen and progestative mixture in purified olive oil is described by the authors. The eruption appeared 9-10 days after the injection and relapsed after each injection. The histological picture was compatible with erythema annulare.

[Cutaneous manifestations of chronic atrophic polychondritis and their relation to aphtosis]. / Les manifestations cutanées de la polychondrite chronique atrophiante et leurs rapports avec l'aphtose

A young woman aged 23 showed the clinical feature of relapsing polychondritis. This disease included recurrent inflammation of right ear, nasal rib and larynx cartilages. She had also arthritis of ankle and wrist. She never had aphtosis before her cartilaginous disease. Buccal and genital erosions similar to aphtae occurred before each recurrent attack of cartilage inflammation. In one instance aseptic vesiculo-pustular and erythema nodosum like lesions occurred. This case raises the question of whether this is a never reported association of two diseases or relapsing polychondritis may have dermatological symptoms bordering aphtosis. The latter hypothesis is supported: firstly by the fact that skin symptoms of aphtosis had been reported separately in cases of relapsing polychondritis (buccal aphtae, pustular eruption, erythema nodosum, recurrent thrombophlebitis); secondly by a case very similar to our (Thivolet, see text) showing a typical feature of relapsing polychondritis with a complete dermatological aspect of aphtosis.