An Algorithmic Approach for the Reconstruction of Nasal Skin Defects: Retrospective Analysis of 130 Cases

Objective: Most of the malignant cutaneous carcinomas are seen in the nasal region. Reconstruction of nasal defects is challenging because of the unique anatomic properties and complex structure of this region. In this study, we present our algorithm for the nasal skin defects that occurred after malignant skin tumor excisions. Material and Methods: Patients whose nasal skin was reconstructed after malignant skin tumor excision were included in the study. These patients were evaluated by their age, gender, comorbities, tumor location, tumor size, reconstruction type, histopathological diagnosis, and tumor recurrence. Results: A total of 130 patients (70 female, 60 male) were evaluated. The average age of the patients was 67.8 years. Tumors were located mostly at the dorsum, alar region, and tip of the nose. When reconstruction methods were evaluated, primary closure was preferred in 14.6% patients, full thickness skin grafts were used in 25.3% patients, and reconstruction with flaps were the choice in 60% patients. Different flaps were used according to the subunits. Mostly, dorsal nasal flaps, bilobed flaps, nasolabial flaps, and forehead flaps were used. Conclusion: The defect-only reconstruction principle was accepted in this study. Previously described subunits, such as the dorsum, tip, alar region, lateral wall, columella, and soft triangles, of the nose were further divided into subregions by their anatomical relations. An algorithm was planned with these sub regions. In nasal skin reconstruction, this algorithm helps in selection the methods for the best results and minimize the complications

Cutaneous Cystic Lesions of the Head and Neck Regions

Objective: Cutaneous cysts of the head and neck regions have been an important problem because of both aesthetic concerns and their predisposition to infection. Material and Methods: Patients operated for cutaneous cysts of the head and neck regions between January 2008 and December 2013 were analyzed retrospectively for patient age and sex, localization and dimensions of the cysts, type of anesthesia used for excision, excision method, and histopathological diagnosis of cysts. The obtained data was compared with that reported in the literature. Results: A total of 164 patients who underwent operations for head and neck cutaneous cysts were included in the study. Epidermoid cysts were the most common type in the head and neck regions. When the localization of the cysts was analyzed, the scalp (26.3%), cheek (21.3%), and periorbital regions (15.2%) were found to be the most common locations. Conclusion: Cutaneous cysts are easy to diagnose; however, as in every tumor, histopathological examination is mandatory after excision. It should not be forgotten that malign lesions may have similar findings with benign ones

Becker nevus syndrome presented with ipsilateral breast hypoplasia

Becker nevus syndrome (BNS) is a rare epidermal nevus syndrome characterized with Becker nevus and ipsilateral breast gland hypoplasia or other skin, skeletal and/or muscle tissue disorders. A 24-year-old woman presented with brown, irregular bordered patch with a diameter of approximately 10 cm which consisted of several small macules on the left breast skin. The ultrasonography and magnetic resonance imaging revealed left breast hypoplasia. Histopathological examination demonstrated minimal acanthosis, papillomatosis, increase in basal layer melanin and hypertrophy of the erector pili muscle. Immunohistochemical staining was positive for androgen in the epidermis, dermal stromal cells and skin appendages. Depending on the clinical and histopathological findings, the patient was diagnosed as BNS. Diagnosis of BNS needs careful examination of pigmented macules and patches since non-hairy BN may be easily overlooked. Patients with BN should be evaluated for associated abnormalities of BNS, in which the severity and extend of ectodermal involvement may differ from patient to other