Angiosarcoma Mimicking Rhinophyma

We report the case of a 61-year-old man showing persistent erythematous macules, plaques, and partially confluent nodules with irregular borders, developed on his nose for one year. During that time the patient underwent several dermatological consultations, and all produced the same diagnosis: rhinophyma. So antibiotic and steroid treatment was carried out without any improvement while the lesions kept growing. When the patient came to our observation, physical examination revealed large, infiltrative, oedematous, erythematous plaques and rare nodules, with superficial telangiectatic vessels. Cervical lymphadenopathy was not detectable. Routine laboratory analysis was normal. Punch biopsy was performed, and histopathology and immunohistochemical studies were consistent with cutaneous angiosarcoma. This is the report of a face angiosarcoma with an unusual and very deceptive clinical presentation

Does postoperative radiation therapy represent a contraindication to expander-implant based immediate breast reconstruction? An update 2012-2014

Post-mastectomy radiotherapy (PMRT) is well known in the plastic surgery community for having a negative impact on expander-implant based immediate breast reconstruction (IBBR), although recently some technical improvements allow better results. Very recent papers would suggest that there is no difference in postoperative complications in patients receiving post-mastectomy radiotherapy using modern techniques. However, study results are often biased by small groups of patients and by heterogeneity of radiotherapy timing, different surgical techniques and measured outcomes

Skin needling in the treatment of the aging neck

The aim of this study was to estimate the efficacy of skin needling in the treatment of the aging neck. Eight patients with aging necks were included in the study. Each patient was treated with 2 sessions of needling. The evaluation of treatment effectiveness was based on changes from baseline on the Global Aesthetic Improvement Scale, the Wrinkle Severity Rating Scale, photographic and ultrasonographic images, and silicone rubber microrelief impressions of a selected neck region before and after therapy. Analysis of the photographs, the degree of irregularity of the surface microrelief, and the ultrasound images showed that, after 2 sessions, the lesions' severity grade was reduced in almost 90% of the patients. The present study presents evidence for the efficacy of skin needling for the aging neck

Medical and Surgical Treatment of Hidradenitis Suppurativa: A Review

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease presenting with painful nodules, abscesses, sinus tracts, and scarring primarily affecting apocrine gland-rich intertriginous areas. HS prevalence ranges from 0.05 to 1%. The central pathogenic event in HS is believed to be the occlusion of the upper part of the folliculopilosebaceous unit, leading to the rupture of the sebofollicular canal with the consequent development of perifollicular lymphohistiocytic inflammation. The HS treatment choices are influenced by disease severity and its individual subjective impact, involving both medical and surgical interventions. However, given the chronic nature of HS, its destructive impact on social, working, and daily life of patients, its management is often frustrating for both the patient and physician. Hence, prompt and effective management strategies are urgently needed and a multidisciplinary approach is advocated. Therefore, in this article, we highlighted the main features of HS (clinical aspects, epidemiology, pathogenesis, diagnostic criteria, classifications, comorbidities, and treatments), so that awareness of this disease might be heightened in primary care physicians and surgeons, who may be the first healthcare providers to see patients with this disease owing to its characteristic clinical presentation (inflammatory nodules, abscesses, sinus tract, etc.)

Primary bilateral malignant melanoma of the lower limbs

Malignant melanoma is the eighth most common cancer in European women. Its incidence is increasing rapidly and it has been demonstrated that this is related to sun exposure. Although few cases of bilateral uveal or choroidal melanoma are described in literature, there are no cases reporting bilateral cutaneous malignant melanoma. We report a singular case of a 43-year-old woman with two primary bilateral melanomas localized on the flexural surface of both legs

Primary bilateral malignant melanoma of the lower limbs

Malignant melanoma is the eighth most common cancer in European women. Its incidence is increasing rapidly and it has been demonstrated that this is related to sun exposure. Although few cases of bilateral uveal or choroidal melanoma are described in literature, there are no cases reporting bilateral cutaneous malignant melanoma. We report a singular case of a 43-year-old woman with two primary bilateral melanomas localized on the flexural surface of both legs

Preliminary result with incisional negative pressure wound therapy and pectoralis major muscle flap for median sternotomy wound infection in a high-risk patient population

Deep sternal wound infection (DSWI) represents a dangerous complication that can follow open-heart surgery with median sternotomy access. Muscle flaps, such as monolateral pectoralis major muscle flap (MPMF), represent the main choices for sternal wound coverage and infection control. Negative pressure incision management system has proven to be able to reduce the incidence of these wounds' complications. Prevena™ represents one of these incision management systems and we aimed to evaluate its benefits. A total of 78 patients with major risk factors that presented post-sternotomy DSWI following cardiac surgery was selected. Thrity patients were treated with MPMF and Prevena™ (study group). Control group consisted of 48 patients treated with MPMF and conventional wound dressings. During the follow-up period, 4 (13%) adverse events occurred in the study group, whereas 18 complications occurred (37·5%) in the control group. Surgical revision necessity and mean postoperative time spent in the intensive care unit were both higher in the control group. Our results evidenced Prevena™ system's ability in improving the outcome of DSWI surgical treatment with MPMF in a high-risk patient population

Collagen induction therapy for the treatment of upper lip wrinkles

Upper lip wrinkles are very common and impair the quality of life of many people due to their perceived unsightly appearance. Several options are available today for their treatment. A new therapeutic option, called collagen induction therapy (CIT), seems to be effective and safe for the treatment of upper lip wrinkles. The aim of this study is to demonstrate the efficacy and safety of CIT in the treatment of upper lip wrinkles. Ten female subjects, aged 50-65 years old, with upper lip wrinkles were enrolled. Each patient was treated with a specific tool in two sessions. Using a digital camera, photographs were taken of all the patients to evaluate the depth of the wrinkles and a silicon-print technique was used to obtain a microrelief impression of the wrinkles. Data of the cutaneous casts were analyzed by computerized image analysis. Analysis of the patients' photographs, supported by the sign test, and of the degree of irregularity of the surface microrelief, supported by Fast Fourier Transform and by wrinkle image processing, showed that, after only two sessions, the wrinkles' severity grade in most patients was greatly reduced. The present study confirms CIT as an effective and safe technique to improve upper lip wrinkles