A Complication in Hypospadias Surgery Due to Anchoring Suture

The complication rates are still 1–90% both in proximal and distal hypospadias regardless of the surgeon’s experience and the usage of most developed techniques. The literature survey revealed few complications of glans penis including meatal stenosis, prolapsus and retraction. Despite our literature survey, we could not find any article concerning the permanent scar tissue at the dorsal part of glans following hypospadias surgeries. A new complication can be added to these, concerning glans which is the formation of postoperative scar tissue as a reaction to suture material used in traction, stent anchoring or both. The aim of this paper is to demonstrate four cases which had glanular scar due to traction suture following the surgical procedures for hypospadias repair

Warfarin-Induced Leukocytoclastic Vasculitis And Scin Necrosis

Oral antikoagülanlar venöz ve arteryal embolileri önlemede ve tedavisinde yaygın olarak kullanılan ajanlardır. Doku nekrozu ve lökositoklastik vaskülit (LV) warfarine bağlı cilt reaksiyonlarındandır. Biz burada warfarin kullanırken ortaya çıkan LV olgusunu sunduk. Altmış bir yaşında erkek hasta, kronik obstruktif akciğer hastalığı (KOAH), kalp yetmezliği tanısı ile takip edilen ve 5 ay önce pulmoner emboli tanısı alan ve warfarin kullanan hasta son 2 haftadır artan nefes darlığı, öksürük, balgam çıkarma şikayetleri ile başvurdu. Fizik muayenesinde ayaklarında yer yer makülopapüler döküntüleri vardı. Hastanın takipte ayaklarında makülopapüler döküntüleri arttı ve ödemi gelişti, alt eksremitelerinde nekroze görünümler ve sırtında makülopapüler döküntüler ortaya çıktı. Warfarine bağlı cilt nekrozu ön planda düşünülen hastanın coumadini kesildi. Cleaxan tedavisine geçildi. Hastaya cilt biopsisi yapıldı. LV ile uyumlu olarak değerlendirildi. Kolşisin ve prednol 40 mg başlandı. Hastanın bilateral bacaklarındaki ve sırtındaki lezyonlarda belirgin gerileme izlendi. Sonuç olarak, warfarin kullanan hastalarda yeni gelişen cilt bulguları dikkatlice değerlendirilmeli ve warfarinin potansiyel yan etkileri göz önünde bulundurulmalıdır.Oral anticoagulants are commonly used to prevent and treat venous and arterial embolism.Warfarin induced skin reactions include tissue necrosis and leukocytoclastic vasculitis (LV). Warfarin-induced LV case is presented here. 61 years old male patient. He has been followed-up for the diagnosis of chronic obstructive pulmonary disease (COPD), cardiac failure. He had been diagnosed as pulmonary embolism and started to use warfarin 5 months ago and admitted to hospital with the complaints of progressive dyspnea, cough, and phlegm in the last 2 weeks. According to the physical examination, he had sporadic maculopapular rash. Maculopapular rash increased in his feet during follow-up, and edema developed. After a while, necrosis signs in lower extremities and maculopapular rash in his back were occurred. Main diagnosis was considered as warfarin-induced skin necrosis, and coumadin was ceased. Low molecular weight heparine treatment was initiated. According to skin biopsy, it was compatible with LV. Colchicine, prednol 40 mg were initiated. Significant lesion improvement was observed on the bilateral legs and back of the patient. In conclusion, New skin signs should be evaluated carefully and potential side effects should be considered in the patients on warfarin