Synergic effect of buccal fat pad pedicled flap and dermal acellular matrix for large cheek defect

Introduction & Objectives: Reconstruction of large defects of the upper cheek defects still remains a challenge for the surgeon, than can apply different techniques. We present a new method involving the use of a dermal regeneration template to achieve an improved, faster healing of pedicled buccal fat flap in a 75-years-old woman affected by melanoma of the upper-middle cheek. The tumor involved soft tissue, zygomatic arch and periocular fact. Material & Methods: The choice of the surgical technique consisted first in the creation of a buccal fat pad to restore the important lack of tissue over the underlying bones, then in the positioning of a dermal acellular matrix. Three weeks later, once the neodermal formation was finished, a split thickness graft was placed. Results: This is a not yet described association that represents a good surgical option for the restoration of large cheeck defects that allows good functional and cosmetic result in older patient when minimal surgical invasion and operative duration are necessary because of a patient’s general condition. The post-operative course with this surgical technique was regular and a good functional result was achieved. Conclusions: This technique provides an adequate functional coverage, a restoration of soft tissue lacking and an acceptable cosmetic result without ectropion

Obesity and Wound Healing: Focus on Mesenchymal Stem Cells

Chronic wounds represent nowadays a major challenge for both clinicians and researchers in the regenerative setting. Obesity represents one of the major comorbidities in patients affected by chronic ulcers and therefore diverse studies aimed at assessing possible links between these two morbid conditions are currently ongoing. In particular, adipose tissue has recently been described as having metabolic and endocrine functions rather than serving as a mere fat storage deposit. In this setting, adipose-derived stem cells, a peculiar subset of mesenchymal stromal/stem cells (MSCs) located in adipose tissue, have been demonstrated to possess regenerative and immunological functions with a key role in regulating both adipocyte function and skin regeneration. The aim of the present review is to give an overview of the most recent findings on wound healing, with a special focus on adipose tissue biology and obesity

Self-healing CD30- T-clonal proliferation of the tongue: report of an extremely rare case

The etiology of traumatic ulcerative granulomas with stromal eosinophilia (TUGSE) is not clear, traumatic irritation having advocated as the most likely cause. TUGSEs are typically self-limiting slow-healing lesions of the oral mucosa with unclear pathogenesis, commonly manifesting as a rapidly developing, long-lasting ulcer

Crescentic flap for the reconstruction of the nose after skin cancer resection

Purpose Non-melanoma skin cancers are the most frequent skin tumours; in 25.5% of cases, they are reported to affect the nasal area. For an excellent surgical outcome, first of all the radical excision of the lesion is important, with appropriate margins of healthy skin in order to avoid recurrences. Moreover is important to achieve a good aesthetical result, avoiding distortion of the aesthetic units and preserving their functions. Material and methods We have applied the modified crescentic flap, described by Smadja in 2007, to 24 nasal skin defects left by oncologic surgery. It consists of the crescent-shaped resection of Burow's triangle all around the alar groove that allows the advancement of the flap to the tip of the nose, hiding the scar in the alar groove. Results The outcome and the long-term follow-up were completely satisfactory both for patients and for surgeons. Conclusion For skin defects localized in the midline or paramedian line of the dorsum of the nose, the crescentic flap seems to be a good solution to obtain the better aesthetic result with respect to both anatomy and function of the nasal area, sparing the patient a second intervention or an overly invasive procedure

High Magnification Digital Dermoscopy of Basal Cell Carcinoma: A Single-centre Study on 400 cases.

The aim of this study was to assess the frequency of classic dermoscopic basal cell carcinoma (BCC) features and the sensitivity of new descriptors, such as light brown nests (homogeneous and structured) only visible employing a high magnification digital videomicroscope. A retrospective analysis of 2,024 highly magnified digital images referring to 400 BCCs was performed by 3 independent observers, who assessed 11 classic BCC descriptors and the new ones. Light brown nests were detected in 40.5% of BCCs. Homogeneous ones were observable in 17.8%, and structured nests in 32.8%. Light brown nests were visible in 14.3% of non-pigmented lesions, whereas in the pigmented groups these were observed in 42-54% of the cases. We suggest that brown nests described in this study may improve early recognition of superficial BCCs and of non-pigmented or slightly pigmented ones that may lack classic dermoscopic patterns

Consumo Digital y Participación Ciudadana: la Perspectiva de la Juventud Partidaria Brasileña

The Brazilian youth has been a protagonist in terms of political mobilization, starting from, for example, the emergence and expansion of protest movements and new forms of political action, especially with the use of digital technologies. The objective of this article is to evaluate the political trajectory of representatives of the national youth of 10 Brazilian parties. To do this, in-depth interviews were conducted between November and December 2019. From the material collected, the data are presented in three items: i) profile of the young people interviewed, ii) consumption of information on politics; and iii) trajectory and political culture. The results obtained point to the discussion of four main themes: a) digital and participatory exclusion; b) access to information and quality of democracy; c) variables of the political culture and d) communicative and potential dimension of the internet as a public sphere. In the current scenario, information and communication technologies can be important facilitating instruments of social mobilization, as a means or tool of collective citizen action. Just as information and communication technologies allow greater access to information, they also allow online practices of citizen participation, potentially becoming a virtual public sphere, as well as the uses and appropriations developed by the Brazilian party youth indicate.La población joven brasileña ha sido protagonista en las movilizaciones políticas a partir, por ejemplo, de la emergencia y expansión de los movimientos de protesta y de nuevas formas de acción política, sobre todo con el uso de tecnologías digitales. El objetivo de este artículo es evaluar la trayectoria política de representantes de la juventud nacional de 10 partidos brasileños. Para ello, se realizaron entrevistas en profundidad, entre noviembre y diciembre de 2019. A partir del material recolectado, los datos se presentan en tres ítems: i) perfil de los jóvenes entrevistados, ii) consumo de información sobre política; y iii) trayectoria y cultura política. Los resultados obtenidos apuntan a la discusión de cuatro temáticas principales: a) exclusión digital y participativa; b) acceso a la información y calidad de la democracia; c) variables de la cultura política; y, d) dimensión comunicativa y potencial de Internet como esfera pública. En el escenario actual, las tecnologías de información y comunicación pueden ser importantes instrumentos facilitadores de la movilización social, como medio o herramienta de la acción colectiva ciudadana. Así como las tecnologías de información y comunicación permiten un mayor acceso a las informaciones, también permiten prácticas online de participación ciudadana, volviéndose, potencialmente, una esfera pública virtual y, asimismo, indican los usos y las apropiaciones desarrollados por la juventud partidaria brasileña

Surgical management and oncological follow-up of cutaneous squamous cell carcinomas arising in epidermolysis bullosa patients

Background Hereditary epidermolysis bullosa (EB) is a rare genodermatosis characterized by skin fragility and blistering of the skin and mucous membranes in reaction to minimal traumas. The development of cutaneous squamous cell carcinomas (cSCCs) is one of the most common medical complications in junctional and dystrophic forms of the disease. Complete surgical excision of cutaneous tumors represents the gold standard of treatment. However, not only recognition of cSCCs can be challenging in the affected skin but also wound closure after surgical excision poses a great therapeutic challenge in EB patients. The aim of our study was to analyze the postoperative outcomes of such patients in order to have a better knowledge of the main critical issues in their surgical management and oncological follow-up. Methods We retrospectively identified a cohort of five EB patients treated at Modena University Hospital. Collected data included patient age and sex, date of cSCC diagnosis, relapses/recurrences, site of the neoplasm, number of surgical interventions, use of dermal substitutes, and postoperative infections. Results A total of 26 cSCCs were detected in our cohort. Forty-one surgical interventions were necessary to achieve excision of cSCCs with clear margins, varying from 1 to 4 surgical sessions per cSCC. Dermal substitutes were used in most cases but carried a higher infectious risk. Conclusions EB patients tend to develop numerous cSCCs that often relapse even after complete excision with clear margins. These results stress the importance of early cSCC diagnosis and strict postsurgical follow-up

Negative Pigment Network Identifies a Peculiar Melanoma Subtype and Represents a Clue to Melanoma Diagnosis: A Dermoscopic Study of 401 Melanomas

The dermoscopic descriptor "negative pigment network" (NPN) has been reported in several types of melanocytic and non-melanocytic lesions, although it has a higher frequency of association with melanoma and Spitz naevus. In a study of 401 consecutive melanomas, excluding facial, acral and mucosal locations, the frequency and variability of NPN were investigated, and the results of NPN correlated with clinical and histopathological data. NPN of any extension was found in 27% of melanomas, most frequently invasive and arising from a naevus on the trunk of young subjects. Seven percent of melanomas in the study population showed presence of NPN in more than half of the lesion area; most of these did not show typical dermoscopic melanoma features. The authors propose a new melanoma subtype, in which extensive NPN should be considered as a diagnostic indicator