Prevalence of novel gamma HPV types 223 and 225 in oral cavity and skin of Indian normal and neoplastic participants.

Gamma-papillomaviruses, though traditionally classified as cutaneotropic, actual tissue tropism is largely unexplored. This study aimed to evaluate the tissue-specific prevalence of two novel-HPV 223 and 225 in samples of oral mucosa and keratinized epithelium of varied skin parts from 226 female and male subjects, with or without neoplastic/dysplastic lesions in oral cavity or cervix. The gamma-human papillomavirus (gamma-HPV) 223 and 225 DNA presences were determined by polymerase chain reaction (PCR) ursing the HPV type-specific primers and confirmed by Sanger sequencing. Viral load in the HPV 223 and HPV 225 positive samples were determined by absolute real-time quantification method. Alpha-HPV DNA prevalence was also checked in oral mucosa to ascertain coinfection status. Novel HPV 223 was present in 4.4% (10/226) oral mucosal samples of the study population; interestingly all were females with no prevalence in their corresponding skin swab samples. Whereas, the prevalence of HPV 225 was found both in the skin and oral mucosa of 28.2% (N = 37/131) female and 17.9% (N = 17/95) male participants. Alongside, HPV 223 viral load was found to be significantly higher (p = 0.02 < 0.05) in the oral mucosa of diseased participants, whereas, HPV 225 viral load was higher in the oral mucosa of normal participants. Our results suggest that gamma-HPV 223 has its prevalence only in the oral mucosal epithelium, whereas, HPV 225 has its prevalence on both mucosal and keratinized skin epithelium, indicating its dual tropism nature.

Like Versus Unlike: Closure of a Moderate-sized Circular Tissue Defect Following Wide Local Excision of Primary Cutaneous Squamous Cell Carcinoma of Face by Rhombic Transposition Flap with Modification.

Closure of a circular tissue defect in the head-neck-face region is challenging because most transposition flaps are rhombic or triangular. For a tension-less closure, both rhombic transposition flap and the circular tissue defect need to be engineered maintaining strict geometric calculations. The present illustration demonstrates a modified rhombic transposition flap with greater freedom in rotation and mobility for closing a moderate-sized circular defect resulting from wide local excision of cutaneous squamous cell carcinoma in the mid-face. The circular shape of the primary tissue defect did not need to be altered. The authors revisited an earlier published technique in the process, adding their own modification to the rhombic transposition flap.

Pectoralis Major Myofascial (PMMF) Flap as a Valuable Alternative to Microvascular Free Flaps (MFF) in Females with Advanced Oral Squamous Cell Carcinomas: A Retrospective Institutional Analysis.

India contributes 60% of HNC cases worldwide among which OSCC has become the most common cancer in males and second most common in females (NCRCR 2020). As most cases present in advanced stage, surgical excision followed by flap reconstruction becomes mandatory to achieve functionality. Due to various logistics and financial issues, microvascular free flap reconstruction is not feasible in every case. Also in females, reconstruction with PMMC is challenging as it violates normal breast contour. As an alternative, we have explored the affectivity of pectoralis major myofascial (PMMF) flaps. A retrospective analysis was undertaken only in female patients with advanced stage oral malignancies who underwent surgery between September 2021 and January 2023. Patients having cutaneous involvement or requiring local flap reconstruction were excluded. Total 43 female patients were included in the study. Among them 8 had Tongue carcinoma and 35 had Alveobuccal carcinoma. 24 patients underwent PMMF reconstruction, whereas 19 patients underwent MFF reconstruction. The complication rates were 12.1% (3 out of 24) in PMMF and 89.4% (17 out of 19 cases)in MFF. Among PMMF group, 1 major complication (death, unrelated to flap) and 2 minor complications (wound infection) occured. Among the MFF group, major complications were e.g. Flap failure requiring re-exploration surgery (n = 4), wound dehiscence (n = 2), bleeding/hematoma (n = 1), donor site complications (n = 6). The minor complications being wound infections (n = 4). The goals of reconstruction of defects in oral cavity cancers are mainly functional and cosmetic integrity. Although MFF's provide a wide range of options for reconstruction of complex defects, as per our study the PMMF flap was more reliable and had lesser complications. PMMF flap is an invaluable alternative to MFF's in female patients for both reconstruction and breast contour preservation.

Primary Sinonasal Tuberculosis: A Diagnostic Challenge.

Primary sinonasal tuberculosis remains a diagnostic challenge as it mimics sinonasal granulomatous disease or neoplasms. Its characteristic signs and symptoms may be non-specific and highly variable. Here we report a unique clinical condition of a 24-year-old man who presented with unilateral nasal obstruction and epiphora for 2 years. He was without any comorbidity, was immunocompetent, and was otherwise healthy. Subsequent investigations, including a computed tomography scan of the paranasal sinuses, and perioperative findings revealed a sinonasal mass involving the lateral nasal wall and paranasal sinuses. The histopathology was consistent with the features of tuberculosis. There was no evidence of pulmonary or any other primary tubercular foci elsewhere in the body, suggesting the diagnosis of primary sinonasal tuberculosis.