RESUMEN
Brooke-Spiegler syndrome is a rare disorder, characterized by the development of skin adnexal tumors, including cylindromas, trichoepitheliomas, spiradenomas. Although these neoplasms are benign in most patients, a malignant transformation can rarely occur. Furthermore, an occasional association between cutaneous adnexal tumors and basal cell adenoma as well as adenocarcinoma of the parotid gland has been rarely described, with approximately 20 cases reported. We report a case of BSS presenting with a malignant eccrine spiradenocylindroma, in a patient with previous history of parotid basal cell tumor.
RESUMEN
In case of severe acute respiratory distress syndrome (ARDS), as in coronavirus disease 2019 (COVID-19) affected patients, the invasive ventilation in prone position can improve the prognosis, albeit with an increased risk of facial pressure ulcers. In this report, we will relate a case of facial pressure ulcers in a SARS-CoV-2 positive 50 year-old woman with the aim to describe the high-complexity management of COVID 19 in which healthcare professionals across the world are still involved.
RESUMEN
BACKGROUND: Inverted nipples are prevalent in 3% to 10% of women and can often cause functional, psychological, and aesthetic problems. OBJECTIVES: The authors sought to treat inverted nipples and restore the aesthetic appearance of the nipple while minimizing ductal disruption, preserving the ability to breast-feed, and reducing recurrence rates. METHODS: A retrospective review was performed on a total of 161 inverted nipples in 86 consecutive patients who underwent correction of inverted nipples at Oslo Plastic Surgery Clinic. Mean age at operation was 28.7 years and mean follow-up period was 14 months. A novel technique with central tunnelization of the retracted fibers/ducts was employed in 39 patients (45%); partial incision of the center of the inversion through a tunnel in 31 patients (36%); and total cut of the lactiferous ducts in 16 patients (19%). Fat grafting was utilized as support in 14 patients (26 nipples). Postoperatively, nipples were suspended for 4 weeks with a manually constructed device. RESULTS: Most patients had moderate (grade 2, 40 patients) or severe (grade 3, 52 patients) nipple inversion. Infection occurred in 4 patients and 2 patients had local irritation. Recurrence was seen in 32 patients (55 nipples) after the first operation, in 6 patients (6 nipples) after the second operation, and in 1 patient (1 nipple) after the third operation. CONCLUSIONS: The authors propose a treatment algorithm that addresses important therapeutic goals when treating inverted nipples. Clinical examination is crucial to determine the method to be employed. The new central tunnel method and fat grafting to support the nipple are promising, although additional follow-up is necessary.
