Tunneled Island Flaps for the Reconstruction of Nasal Defects: A 21-Case Series.

(1) Background: The reconstruction of cutaneous defects following surgical procedures in the nasal pyramid presents a challenge due to the limited amount of available tissue. In cases of larger defects, skin from adjacent units is used. Traditionally, two-stage surgical flaps have been employed for reconstructing these defects. Tunnelized island flaps allow for the one-stage surgical reconstruction of nasal pyramid defects, using tissue from the forehead or cheek for the flap. (2) Methods: Descriptive retrospective study of 21 consecutive patients who underwent surgery for defects on the nasal pyramid using tunnelized island flaps. (3) Results: Surgical reconstruction was performed in 21 patients with basal cell carcinomas, 14 of them using the melolabial island flap and 7 using the paramedian forehead island flap. In all cases except one, clear histological margins were obtained. Immediate complications were mild and minor. It is worth noting the trapdoor effect complication, which improved over time in most cases, resulting in a satisfactory cosmetic outcome. No tumor recurrences were observed during an average follow-up period of 17.7 months. (4) Conclusions: Tunnelized island flaps allow for single-stage reconstruction of nasal pyramid defects, yielding excellent cosmetic results by utilizing adjacent skin. This procedure demands a certain level of skill but is associated with minimal complications, making it a valuable alternative in reconstructive dermatological surgery.

[Digital acrometastasis]. / Metástasis digital acral.

Cutaneous metastases are infrequent and in some cases represent the first manifestation of an unknown neoplasm. Acrally located metastases are particularly rare, and the prognosis is very poor, with a survival time of only a few months. Although the clinical presentation varies, they are generally confused with an infectious or inflammatory process, which delays diagnosis. When they are located on the fingers, the most frequent cause is lung carcinoma, while those located on the toes are usually due to tumors in the genitourinary tract. The histology of the metastasis is similar to that of the primary tumor, although less differentiated. In most acrometastases, first the bone and then the skin are affected. Treatment is palliative. We present the case of a patient with a metastasis on the big toe as an initial sign of a previously unknown lung tumor.

Metástasis digital acral / Digital acrometastasis

Las metástasis cutáneas son poco frecuentes y en algunos casos representan la primera manifestación de una neoplasia no conocida. Las metástasis de localización acral son particularmente raras y el pronóstico es muy malo, con una supervivencia de pocos meses. Aunque la clínica es variable, generalmente se confunden con un proceso infeccioso o inflamatorio, retrasándose el diagnóstico. Cuando se localizan en los dedos de la mano la causa más frecuente es el carcinoma de pulmón, mientras que las localizadas en los dedos de los pies suelen deberse a tumores del tracto genitourinario. La histología de la metástasis es similar al primario aunque más indiferenciada. En la mayoría de las metástasis acrales se afecta primero el hueso y secundariamente la piel. El tratamiento es paliativo. Presentamos el caso de un paciente con una metástasis en el primer dedo del pie como signo inicial de un tumor pulmonar no conocido previamente

Cutaneous metastases are infrequent and in some cases represent the first manifestation of an unknown neoplasm. Acrally located metastases are particularly rare, and the prognosis is very poor, with a survival time of only a few months. Although the clinical presentation varies, they are generally confused with an infectious or inflammatory process, which delays diagnosis. When they are located on the fingers, the most frequent cause is lung carcinoma, while those located on the toes are usually due to tumors in the genitourinary tract. The histology of the metastasis is similar to that of the primary tumor, although less differentiated. In most acrometastases, first the bone and then the skin are affected. Treatment is palliative. We present the case of a patient with a metastasis on the big toe as an initial sign of a previously unknown lung tumor

Síndrome de Buschke-Ollendorff familiar / Family Buschke-Ollendorff syndrome

El síndrome de Buschke-Ollendorff es un trastorno de herencia autosómica dominante que cursa clínicamente con nevos elásticos y osteopoiquilia. Histológicamente la mayoría de los casos presentan en las lesiones cutáneas una cantidad normal de colágeno y aumento de fibras elásticas, aunque se han descrito formas abortivas con afectación cutánea, con disminución de fibras elásticas y ausencia de alteraciones óseas. Se describe el caso de una mujer de 41 años con criterios de síndrome de Buschke-Ollendorff y el de su hija de 2 años que podría presentar una forma de Buschke-Ollendorff abortiva

Buschke-Ollendorff syndrome is an autosomal dominant disorder whose clinical course includes elastic nevi and osteopoikilosis. Histologically, most cases present with a normal amount of collagen in the skin lesions and an increase in elastic fibers, although abortive forms with skin involvement have been described, with a decrease in elastic fibers and an absence of bone alterations. We describe the case of a 41-year-old woman with Buschke-Ollendorff syndrome criteria, and that of her 2-year-old daughter who might present an abortive form of Buschke-Ollendorff

[Family Buschke-Ollendorff syndrome]. / Síndrome de Buschke-Ollendorff familiar.

Buschke-Ollendorff syndrome is an autosomal dominant disorder whose clinical course includes elastic nevi and osteopoikilosis. Histologically, most cases present with a normal amount of collagen in the skin lesions and an increase in elastic fibers, although abortive forms with skin involvement have been described, with a decrease in elastic fibers and an absence of bone alterations. We describe the case of a 41-year-old woman with Buschke-Ollendorff syndrome criteria, and that of her 2-year-old daughter who might present an abortive form of Buschke-Ollendorff.