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Chuang WC, Ueng SH, Chuang WY, Chan KC. Nodular mass-A case of auricular schwannoma. EAR, NOSE & THROAT JOURNAL 2024; 103:535-537. [PMID: 35057654 DOI: 10.1177/01455613211068001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2024] Open
Abstract
Schwannomas are benign tumors derived from the sheath of Schwann cells. Though it is common to see schwannomas in the head and neck region, auricular schwannomas are rare and only few cases have been reported. There are no distinguishing clinical findings or images; therefore, the histopathological diagnosis is mandatory. We describe a case of auricular schwannoma with clinical pictures and discuss the differential diagnoses according to histopathologic findings.
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Affiliation(s)
- Wen-Ching Chuang
- Department of Education, Chang Gung Memorial Hospital, Linkou, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shir-Hwa Ueng
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Pathology, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Wen-Yu Chuang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Pathology, Chang Gung Memorial Hospital, Linkou, Taiwan
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Kai-Chieh Chan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Otology, Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan
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2
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Colao B, Khachemoune A. Mohs micrographic surgery challenges and new technologies to optimize care of cutaneous malignancies of the ear. Arch Dermatol Res 2024; 316:320. [PMID: 38822894 DOI: 10.1007/s00403-024-03127-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 06/03/2024]
Abstract
Cutaneous malignancies affecting the ear, exacerbated by extensive ultraviolet (UV) exposure, pose intricate challenges owing to the organ's complex anatomy. This article investigates how the anatomy contributes to late-stage diagnoses and ensuing complexities in surgical interventions. Mohs Micrographic Surgery (MMS), acknowledged as the gold standard for treating most cutaneous malignancies of the ear, ensures superior margin control and cure rates. However, the ear's intricacy necessitates careful consideration of tissue availability and aesthetic outcomes. The manuscript explores new technologies like Reflectance Confocal Microscopy (RCM), Optical Coherence Tomography (OCT), High-Frequency, High-Resolution Ultrasound (HFHRUS), and Raman spectroscopy (RS). These technologies hold the promise of enhancing diagnostic accuracy and providing real-time visualization of excised tissue, thereby improving tumor margin assessments. Dermoscopy continues to be a valuable non-invasive tool for identifying malignant lesions. Staining methods in Mohs surgery are discussed, emphasizing hematoxylin and eosin (H&E) as the gold standard for evaluating tumor margins. Toluidine blue is explored for potential applications in assessing basal cell carcinomas (BCC), and immunohistochemical staining is considered for detecting proteins associated with specific malignancies. As MMS and imaging technologies advance, a thorough evaluation of their practicality, cost-effectiveness, and benefits becomes essential for enhancing surgical outcomes and patient care. The potential synergy of artificial intelligence with these innovations holds promise in revolutionizing tumor detection and improving the efficacy of cutaneous malignancy treatments.
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Affiliation(s)
- Bliss Colao
- College of Medicine, University of Florida, Gainesville, FL, USA
| | - Amor Khachemoune
- Department of Dermatology, SUNY Downstate and Veterans Affairs Hospital, 800 Poly Place, Brooklyn, NY, 11209, USA.
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3
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Dmytrzak A, Lewandowska K, Boroń A, Łoniewska B, Grzesch N, Brodkiewicz A, Clark JSC, Ciechanowicz A, Kostrzewa-Nowak D. No Association of Polymorphisms in the Genes Encoding Interleukin-6 and Interleukin-6 Receptor Subunit Alpha with the Risk of Keloids in Polish Patients. Int J Mol Sci 2024; 25:5284. [PMID: 38791322 PMCID: PMC11121548 DOI: 10.3390/ijms25105284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 05/09/2024] [Accepted: 05/11/2024] [Indexed: 05/26/2024] Open
Abstract
A keloid is a benign fibroproliferative hypertrophy of scar tissue that extends outside the original wound and invades adjacent healthy skin. Keloid formation is thought to be a complex process including overactivity of the interleukin-6 signaling pathway and genetic susceptibility. The aim of the study was to investigate possible associations between rs1800797, rs1800796, and rs1800795 polymorphisms in the promoter of the IL6 gene encoding interleukin-6 and the rs2228145 polymorphism in the IL6R gene encoding the interleukin-6 receptor subunit alpha with the predisposition to keloids in Polish patients. The genetic polymorphisms were identified either using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) or sequencing of samples of genomic DNA extracted from blood leukocytes of 86 adult patients with keloids and 100 newborns comprising a control group. No significant differences in the distributions of IL6 or IL6R alleles or genotypes were found between keloid patients and newborn controls. There were also no significant differences between both groups in the distribution of IL6 haplotypes. The IL6 rs1800797, rs1800796 and rs1800795 and IL6R rs2228145 polymorphisms were not found to predispose individuals in the study group to keloids. IL6 promoter haplotypes were not found to be associated with a higher risk of keloids in the studied group.
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Affiliation(s)
| | - Klaudyna Lewandowska
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.L.); (A.B.); (N.G.); (J.S.C.C.); (A.C.)
| | - Agnieszka Boroń
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.L.); (A.B.); (N.G.); (J.S.C.C.); (A.C.)
| | - Beata Łoniewska
- Department of Neonatal Diseases, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Natalie Grzesch
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.L.); (A.B.); (N.G.); (J.S.C.C.); (A.C.)
| | - Andrzej Brodkiewicz
- Department of Pediatrics, Child Nephrology, Dialysotherapy and Management of Acute Poisoning, Pomeranian Medical University, 70-780 Szczecin, Poland;
| | - Jeremy S. C. Clark
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.L.); (A.B.); (N.G.); (J.S.C.C.); (A.C.)
| | - Andrzej Ciechanowicz
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.L.); (A.B.); (N.G.); (J.S.C.C.); (A.C.)
| | - Dorota Kostrzewa-Nowak
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-111 Szczecin, Poland; (K.L.); (A.B.); (N.G.); (J.S.C.C.); (A.C.)
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Singh K, Beniwal M, Sharma A, Singh P, Kumar A, Anshul. Reconstruction of Partial Defect of Ear in a Tertiary Care Institute. Indian J Otolaryngol Head Neck Surg 2024; 76:1825-1835. [PMID: 38566656 PMCID: PMC10982196 DOI: 10.1007/s12070-023-04420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/01/2023] [Indexed: 04/04/2024] Open
Abstract
Auricle is the outward visible part of ear and composed of skin and cartilage. Auricle due to its standout and projected position is more vulnerable to get injured and cause distortion of the facial aesthetics. Reconstruction of the ear defect should be individualized depending on the defect size, location, nearby skin, patient requirement and surgeon experience. To present the results of various reconstructive options for partial ear defect which will aid in decision making among reconstructive options available. Reconstruction was individualized considering the defect size, depth, location, surrounding skin. In upper 1/3 defect reconstructive options include Antia-Buch chondrocutaneous advancement flap, autogenous cartilage with temporoparietal fascial flap, for middle 1/3 defect options include retroauricular soft tissue tube flap, diefenbach procedure, Autogenous cartilage graft and temporoparietal fascial flap, for lower 1/3 defect reconstructive options include pre auricular flap, triangular repair method, Zenteno Alanis technique. Reconstruction with various techniques results in aesthetically good outcomes. There is no major complication seen in any patient. Reconstruction of ear defect with various options available has good outcome. Planning is important part in reconstruction process. Reconstructive option chosen for a ear defect should be individualized depending on patient characteristics, surgeon experience.
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Affiliation(s)
- Kuldeep Singh
- Department of Burns and Plastic Surgery, Pt. B.D.Sharma PGIMS Rohtak, 1150 Sector 1, Rohtak, Haryana 124001 India
| | - Meenu Beniwal
- Department of Burns and Plastic Surgery, Pt. B.D.Sharma PGIMS Rohtak, 1150 Sector 1, Rohtak, Haryana 124001 India
| | - Abhishek Sharma
- Department of Burns and Plastic Surgery, Pt. B.D.Sharma PGIMS Rohtak, 1150 Sector 1, Rohtak, Haryana 124001 India
| | | | - Akshay Kumar
- Department of Burns and Plastic Surgery, Pt. B.D.Sharma PGIMS Rohtak, 1150 Sector 1, Rohtak, Haryana 124001 India
| | - Anshul
- Department of Anaesthesia, Pt. B.D.Sharma PGIMS, Rohtak, India
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Mane BS, Gavali RM. Our Experience at Tertiary Medical College-Intralesional Injection of Triamcinolone Acetonide Versus Injection Verapamil Following Keloidectomy with Fillet Flap in Auricular Keloids. Indian J Otolaryngol Head Neck Surg 2024; 76:237-244. [PMID: 38440636 PMCID: PMC10908903 DOI: 10.1007/s12070-023-04132-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 08/01/2023] [Indexed: 03/06/2024] Open
Abstract
Keloid, which forms as an excessive tissue response to trauma to the skin, is a benign, hyperproliferative, recurrent growth of dermal collagen without a quiescent or regressive period throughout the process of wound healing. The aim of this study was to evaluate patient satisfaction with treatment and to compare the efficacy of intralesional injection of triamcinolone acetonide against verapamil after keloidectomy with fillet flap in auricular keloids. Our study was Duration based prospective observational study with a Duration of two years from June 2021 till May 2023 with study population inclusive of 50 patients aged between 20 and 70 years having recurrent keloid(s) over the pinna of any size or site. Keloidectomy with fillet flap and intralesional injection of trimcinolone acetonide was performed on 25 patients (30 keloids) in Group A, and keloidectomy with fillet flap and intralesional injection of verapamil was performed on 25 patients (30 keloids) in Group B. With a recurrence rate of 27%, eight keloids in Group A patients had an early recurrence three months following surgery. At nine months, nine more mixed-type cases with a 30% recurrence rate resurfaced. Recurrence seen in eight keloids out of 28 showed a 28.57% recurrence rate 12 months following surgery. Three people in Group B with three sessile keloids experienced an early recurrence at three months after surgery, with a recurrence rate of 10%. At nine months, four more cases of mixed kind returned, with a recurrence rate of 13%. A recurrence rate of 14.28% was found in 4 of 28 keloids at 12 months postoperatively. The Patient and Observer Scar Assesment Scale scores (POSAS scores) were consistently higher than Beausang scores at 1 year, indicating high patient satisfaction compared to physician assessment in both groups A and B. A keloid recurrence-free interval of 11.36 months was obtained by the Kaplan-Meier survival test (p < 0.05) in group A. Keloid recurrence-free interval of 10.98 months was evaluated by the Kaplan-Meier survival test (p < 0.05) in group B. Among Keloidectomy with fillet flap surgery with intralesional injection of triamcinolone acetonide (group A) and keloidectomy with fillet surgery with intralesional injection of verapamil (group B), at each follow-up the success rate of group B was higher than group A indicating better trend of success in this group in terms of both absence of recurrence and absence of complications without statistically significant difference between them which shown both procedures more or less similar.
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Affiliation(s)
- Balaji Shankarrao Mane
- Department of Otorhinolaryngology, Ashwini Rural Medical College and Hospital, Solapur, India
| | - Rushali Madhukar Gavali
- Department of Community Medicine, Ashwini Rural Medical College and Hospital, Solapur, India
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Leibowitz R, Koblinski JE, Hogue LM, Cheeley JT, Blalock TW. Dermatologic Conditions of the External Ear: Basics, Updates, and Pearls. Otolaryngol Clin North Am 2023; 56:949-963. [PMID: 37423814 DOI: 10.1016/j.otc.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Cutaneous diseases of the ear encompass a wide range of symptoms, complaints, and factors that negatively impact patients' well-being. These observations are frequently encountered by otolaryngologists and other physicians who treat individuals with ear-related issues. In this document, we aim to offer up-to-date information on diagnosing, predicting outcomes, and treating commonly occurring ear diseases.
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Affiliation(s)
| | - Jenna E Koblinski
- Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road, Atlanta, GA 30322, USA
| | - Latrice M Hogue
- Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road, Atlanta, GA 30322, USA
| | - Justin T Cheeley
- Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road, Atlanta, GA 30322, USA
| | - Travis W Blalock
- Department of Dermatology, Emory University School of Medicine, 1525 Clifton Road, Atlanta, GA 30322, USA.
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Wilsher MJ, Marais J. Recurrent pseudolymphomatous reaction to ear piercing: 20-year history. Pathology 2023; 55:900-903. [PMID: 37385914 DOI: 10.1016/j.pathol.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 02/13/2023] [Accepted: 03/15/2023] [Indexed: 07/01/2023]
Affiliation(s)
- Mark James Wilsher
- North West London Pathology, NWLP, Imperial College Healthcare NHS Trust (ICHNT), Department of Histopathology, Charing Cross Hospital, London, UK; Unilabs IHS, London, UK.
| | - Joe Marais
- Clementine Churchill Hospital, Sudbury Hill, Marlow, UK
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Yousef A, La Monte O, Harmon M, Watson D. Wound healing in the vulnerable: A novel case of postauricular wounds caused by mask ties. JEM REPORTS 2023; 2:100038. [PMID: 37223607 PMCID: PMC10188374 DOI: 10.1016/j.jemrpt.2023.100038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 05/15/2023] [Indexed: 05/25/2023]
Abstract
Background The COVID-19 pandemic has made facial masks an essential part of daily life. While protective facial masks are crucial to help the spread of viral infections, they are common causes of facial skin breakdown, acne, and superficial injuries. Masks with elastic ear loops are also particularly likely to cause ear pressure injuries. Case report Herein, we present a case of a patient experiencing homelessness found to have significant postauricular wounds due to prolonged mask use in the context of the Covid-19 pandemic. These injuries led to bilateral erosion of the helix with partial avulsion of the ear and mask ear loops eroding into cartilage. Why should an emergency physician be aware of this? We describe a rare complication of mask use and highlight the difficulties the COVID pandemic has made in providing adequate care for chronic head and neck wounds amongst the homeless population. While PPE remains an important part of decreasing the risk of the spread of infections, it is important to recognize the vulnerabilities of the homeless population during the COVID pandemic and how best to care for novel auricular wounds.
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Affiliation(s)
- Andrew Yousef
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA, USA
| | - Olivia La Monte
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA, USA
| | - Matthew Harmon
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA, USA
| | - Deborah Watson
- Department of Otolaryngology-Head and Neck Surgery, University of California, San Diego, CA, USA
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Wilkinson AJ, Nader ME, Roberts D, Duvic M, Gunther JR, Dabaja BS, Gidley PW. Survival Outcomes of Patients with Mycosis Fungoides Involving the External Ear and Ear Canal. Laryngoscope 2023; 133:1486-1491. [PMID: 36054317 PMCID: PMC9971327 DOI: 10.1002/lary.30377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/19/2022] [Accepted: 08/09/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Mycosis Fungoides (MF) is the most common subtype of cutaneous T-cell lymphoma. Disease involvement of specific locations may be more significant than simply the symptoms associated with that site; it is possible that involvement of certain sites could be associated with poor prognosis. We aimed to evaluate the outcomes of patients with MF with documented involvement of the EAC and external ear. STUDY DESIGN Retrospective analysis. METHODS We retrospectively reviewed 40 patients with MF that were treated by otologists between 2012 and 2021. RESULTS We report the largest series of patients with MF involving the external ear and EAC. Of the 40 patients included in this study, 17 presented with Mycosis Fungoides in the otologic region (MFO). Of these 17 MFO patients, 2/17 had involvement of the external ear only, 3/17 of the EAC only, 11/17 of both the external ear and EAC, and 1/17 of the periauricular skin. Of note, 11/14 (79%) patients presenting with EAC disease died compared to11/26 (42%) of patients without involvement. In addition, eight of the 13 (62%) patients with external ear involvement died compared to 14/27 (52%) of patients without involvement. Ear canal involvement was associated with a statistically significant shorter overall survival duration in patients with MF (p = 0.03). Furthermore, disease in the EAC was found to have a hazard ratio value of 2.565 (CI 1.102-5.970). CONCLUSIONS Involvement of the EAC by MF portends a poor prognosis. This finding highlights the need for a more in-depth otologic evaluation of patients with MF. LEVEL OF EVIDENCE 4 Laryngoscope, 133:1486-1491, 2023.
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Affiliation(s)
| | - Marc-Elie Nader
- Department of Head and Neck Surgery, MD Anderson Cancer Center
| | - Dianna Roberts
- Department of Head and Neck Surgery, MD Anderson Cancer Center
| | | | | | | | - Paul W Gidley
- Department of Head and Neck Surgery, MD Anderson Cancer Center
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Ahmednaji NM, Wu XY, Wang YX, Chen XD. Surgical Core Excision With Tongue Flap Closure in Combination With Electron Beam Radiotherapy in the Treatment of Ear Keloids. Dermatol Surg 2023; 49:S58-S63. [PMID: 37116002 DOI: 10.1097/dss.0000000000003778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
BACKGROUND Ear keloids are disfiguring disorders resistant to various treatments. OBJECTIVE The authors aimed to assess the efficacy of surgical treatment of ear keloids in a Chinese population using a tongue flap with electron beam radiotherapy. METHODS The authors conducted a retrospective analysis of 41 patients treated at the Affiliated Hospital of Nantong University between January 2018 and May 2021. Core excision with a tongue flap was performed, followed by 3 days of electron beam radiotherapy and 3 to 6 months of pressure clip application. The Vancouver Scar Scale (VSS) and the Visual Analog Scale (VAS) were used to assess the results. RESULTS The mean age of the patients was 28.10 years (9-61 years). Postoperative follow-up ranged from 5 to 32 months (mean:12.07). The patients underwent 3 days of postoperative radiotherapy followed by pressure clips for 2 to 6 months. Thirty-seven patients had no recurrence, whereas 4 had a mild recurrence (<3 mm in height) with redness and itchiness. The VSS and VASscores significantly decreased. (p < .05). CONCLUSION Excision with a tongue flap and radiotherapy can be used as the primary treatment for ear keloids considering the good outcome and long-term management.
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Affiliation(s)
- Nebil Mahamoud Ahmednaji
- All authors are affiliated with the Department of Dermatology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
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Maciulaitis T, Venciute-Stankevice R, Jakutis N. A successful reconstruction of the upper antihelix defect via postauricular pull-through pedicle flap. Niger J Clin Pract 2022; 25:2073-2076. [PMID: 36537468 DOI: 10.4103/njcp.njcp_416_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
The auricle is a complex anatomic structure with a three-dimensional configuration proper reinstating that poses a substantial reconstructive challenge. The postauricular pull-through flap is perfectly suitable method for the reconstruction of helical and antihelical auricle defects; however, due to its difficult harvest technique, it is not commonly used in a practice. Here we describe a case of a patient with an antihelix defect following basal cell carcinoma (BCC). In our case, the reconstruction was performed via postauricular pull-through pedicle flap, and a satisfactory result was achieved.
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Affiliation(s)
- T Maciulaitis
- Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - R Venciute-Stankevice
- Centre of Plastic and Reconstructive Surgery, Vilnius University Santaros Klinikos, Vilnius, Lithuania
| | - N Jakutis
- Clinic of Rheumatology, Orthopedics, Traumatology and Reconstructive Surgery, Vilnius University, Vilnius, Lithuania
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Hwang NH, Lee NK, Chae JH, Park SH, Yoon ES. The Efficacy of CT-Based Conformal Electron Beam Radiation Therapy After Keloid Excision. Dermatol Surg 2022; 48:435-440. [PMID: 35125441 PMCID: PMC8963517 DOI: 10.1097/dss.0000000000003398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Adjuvant computed tomography-based conformal electron beam radiation therapy (RT) for patients with keloids enables radiation oncologists to customize the target volume with precision and deliver the maximal prescription dose while sparing normal surrounding tissues. OBJECTIVE To report treatment and cosmetic outcomes by the patient's self-assessment survey. METHODS Medical records of patients with keloids, who were treated with postoperative electron beam RT between January 2015 and December 2020, were reviewed. A total of 85 consecutive patients with 136 keloids were included in this study. Subjective cosmetic outcomes were scored by each patient using a 5-point Likert scale survey. RESULTS The median follow-up time was 29.0 months (range, 12.1-77.9 months), and local recurrence was observed in 10 lesions (7.4%). The recurrence rate of keloids occurring in the ear was 5.4%, whereas the recurrence rate of keloids occurring at other body sites was 11.4%. Among the patients who responded to the questionnaire about the cosmetic outcome, 70.2% of patients declared being either very satisfied (44.7%) or satisfied (25.5%). CONCLUSION Surgical excision, followed by CT-based conformal electron beam RT, for patients with keloids ensures a high degree of local control resulting in good cosmetic outcomes.
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Affiliation(s)
- Na-Hyun Hwang
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Nam Kwon Lee
- Department of Radiation Oncology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jung Hyun Chae
- Korea University Medical Center, Seoul, Republic of Korea
| | - Seung-Ha Park
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Eul-Sik Yoon
- Department of Plastic and Reconstructive Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
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Tsuno NSG, Tsuno MY, Coelho Neto CAF, Noujaim SE, Decnop M, Pacheco FT, Souza SA, Fonseca APA, Garcia MRT. Imaging the External Ear: Practical Approach to Normal and Pathologic Conditions. Radiographics 2022; 42:522-540. [PMID: 35119966 DOI: 10.1148/rg.210148] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The external ear (EE) is an osseous-cartilaginous structure that extends from the auricle to the tympanic membrane. It is divided into two parts: the auricle (or pinna) and the external auditory canal (EAC). Given the ease of access to the EE, imaging studies are not always needed to make a diagnosis. However, when lesions block visual access to areas deep to the EE abnormality, complications are suspected, or there is lack of response to treatment, imaging becomes essential. A basic understanding of the embryologic development and knowledge of the anatomy of the auricle and EAC are useful for accurate diagnosis of EE lesions. Congenital, traumatic, inflammatory, neoplastic, and vascular conditions can affect the EE. An overview of the anatomy and embryologic development of the EE is presented, with discussion and illustrations of common and uncommon conditions that affect EE structures and a focus on the CT and MRI features that are of interest to radiologists. CT is usually the first diagnostic modality used to evaluate the EAC and is the superior method for demonstrating bone changes. MRI provides excellent tissue characterization and enables one to better define lesion extension and perineural tumor spread. In addition, a flowchart to facilitate the differential diagnosis of EE abnormalities is provided. Online supplemental material is available for this article. ©RSNA, 2022.
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Affiliation(s)
- Niedja S G Tsuno
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Marco Y Tsuno
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Carlos A F Coelho Neto
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Samir E Noujaim
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Marcos Decnop
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Felipe T Pacheco
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Soraia A Souza
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Ana P A Fonseca
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
| | - Marcio R T Garcia
- From the Divisions of Neuroradiology (N.S.G.T.) and Musculoskeletal Radiology (M.Y.T.), Laboratório Exame, Diagnósticos da América SA, SHLN, Lote 09, Bloco G, Asa Norte, Brasília, DF, Brazil 70770560; Divisions of Head and Neck Imaging (C.A.F.C.N., S.A.S., M.R.T.G.) and Neuroradiology (F.T.P., A.P.A.F.), Laboratórios Alta Excelência Diagnóstica e Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil; Department of Head and Neck Radiology, Oakland University School of Medicine, Beaumont Health System, Royal Oak, Mich (S.E.N.); and Division of Head and Neck Imaging, Instituto Nacional do Câncer (INCA), Rio de Janeiro, Brazil (M.D.)
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14
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Malignant lesions of the ear. Arch Dermatol Res 2021; 314:839-845. [PMID: 34792642 DOI: 10.1007/s00403-021-02304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 10/02/2021] [Accepted: 11/11/2021] [Indexed: 10/19/2022]
Abstract
The dermatologic lesions of the external ear are quite protean and they encompass pre-malignant, malignant and inflammatory entities. The ear is endowed with functional and cosmetic importance and it is part of the "H-zone", which is the area of the head that generally presents tumors that can be considered high risk regardless of their size. As a matter of fact, skin malignancies of the ear tend to have a less benign course compared to the ones located on other areas of the body and complete excision has proven to be challenging. This mini-review provides an overview on the malignant cutaneous lesions of the external ear with a focus on their dermoscopic and reflectance confocal microscopy features. The most prevalent neoplasms of the auricle are squamous cell carcinoma and basal cell carcinoma followed by melanoma. These malignant lesions appear to be more common in men and to have a worse prognosis compared to when they arise from other body districts. There is a relative dearth of large studies centered on the clinical, dermoscopic and reflectance confocal microscopy features of skin cancers of the ear. Hence, further research inquiring into the specific dermoscopic and reflectance confocal microscopy characteristics of the cutaneous malignant lesions of the external ear, if any, are warranted for the future.
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15
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Vaccaro M, Marafioti I, Giuffrida R, Borgia F, Zalaudek I. Clinical and dermoscopic characterization of pediatric Spitz nevi of the ear. Pediatr Dermatol 2021; 38:895-898. [PMID: 34152025 DOI: 10.1111/pde.14616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Spitz nevi of special sites, such as the ear, appear rarely and pose a challenge with worrisome clinical, dermoscopic, or histopathological features. Our aim was to evaluate the morphological findings of a series of Spitz nevi of the ear in order to obtain more knowledge about their clinical-dermoscopic patterns. Of a total of six cases, three main dermoscopic structures were found: pseudonetwork, structureless areas, and cobblestone pattern. Our preliminary findings suggest that dermoscopy may be helpful in improving the diagnostic accuracy of Spitz nevus of the ear and minimize surgery in a sensitive location.
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Affiliation(s)
- Mario Vaccaro
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Ilenia Marafioti
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Roberta Giuffrida
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Francesco Borgia
- Department of Clinical and Experimental Medicine, Dermatology- University of Messina, Messina, Italy.,Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
| | - Iris Zalaudek
- Department of Dermatology and Venereology, University of Trieste, Trieste, Italy
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16
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Levine JM, Ayello EA, Persaud B, Spinner R. Medical Device-Related Pressure Injury to the Ear from a Mask. Adv Skin Wound Care 2021; 34:380-383. [PMID: 34125728 DOI: 10.1097/01.asw.0000752712.31139.c0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
ABSTRACT Mask wearing is now ubiquitous because of the COVID-19 pandemic and has given rise to medical device-related pressure injuries in persons at risk of skin breakdown. The ear has unique anatomy that is particularly susceptible to injury from pressure. In this time of mandatory personal protective equipment requirements in healthcare facilities, protection and assessment of skin in the vulnerable postauricular area are needed. This article presents a case report of a pressure injury on the ear, reviews the anatomy of the ear, and provides strategies for assessment and treatment of pressure injuries in this often overlooked anatomic region.
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Affiliation(s)
- Jeffrey M Levine
- Jeffrey M. Levine, MD, AGSF, CMD, CWS-P, is Associate Clinical Professor of Geriatric Medicine and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, NY; and Consultant, Advantage Surgical and Wound Care, El Segundo, CA. Elizabeth A. Ayello, PhD, MSN, BSN, ETN, RN, CWON, MAPWCA, FAAN, is co-Editor-in-Chief, Advances in Skin and Wound Care , Philadelphia, PA; Faculty Emeritus, Excelsior College School of Nursing, Albany, NY; and President, Ayello Harris & Associates, Inc, Copake, NY. Balwant Persaud, LPN, is Licensed Practical Nurse, Department of Nursing, New Jewish Home, New York, NY. Ruth Spinner, MD, CMD, is Senior Medical Director, The New Jewish Home; Assistant Clinical Professor of Geriatric Medicine and Palliative Care, Icahn School of Medicine at Mount Sinai, New York, NY; and Wound Consultant, Advantage Surgical & Wound Care. Acknowledgments: Dr Ayello was a member of the small working group for the chapter on medical device-related pressure injuries for the 2019 Clinical Practice Guideline for which she received no compensation. Dr Ayello has also served as an advisor to the CMS for long-term care on the Resident Assessment Instrument manual for Section M, pressure injuries. The authors have disclosed no financial relationships related to this article. Submitted October 30, 2020; accepted in revised form February 6, 2020
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17
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Lee DJ, Kwon J, Kim YI, Kwon YH, Min S, Shin HW. Coating Medpor ® Implant with Tissue-Engineered Elastic Cartilage. J Funct Biomater 2020; 11:jfb11020034. [PMID: 32455861 PMCID: PMC7353498 DOI: 10.3390/jfb11020034] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 05/01/2020] [Accepted: 05/07/2020] [Indexed: 12/31/2022] Open
Abstract
Inert biomaterials used for auricular reconstruction, which is one of the most challenging and diverse tasks in craniofacial or head and neck surgery, often cause problems such as capsule formation, infection, and skin extrusion. To solve these problems, scaffold consisting of inert biomaterial, high-density polyethylene (Medpor®) encapsulated with neocartilage, biodegradable poly(DL-lactic-co-glycolic acid) (PLGA) was created using a tissue engineering strategy. PLGA scaffold without Medpor® was created to serve as the control. Scaffolds were vacuum-seeded with rabbit chondrocytes, freshly isolated from the ear by enzymatic digestion. Then, cell-seeded scaffolds were implanted subcutaneously in the dorsal pockets of nude mice. After 12 weeks, explants were analyzed by histological, biochemical, and mechanical evaluations. Although the PLGA group resulted in neocartilage formation, the PLGA-Medpor® group demonstrated improved outcome with the formation of well-surrounded cartilage around the implants with higher mechanical strength than the PLGA group, indicating that Medpor® has an influence on the structural strength of engineered cartilage. The presence of collagen and elastin fibers was evident in the histological section in both groups. These results demonstrated a novel method of coating implant material with engineered cartilage to overcome the limitations of using biodegradable scaffold in cartilage tissue regeneration. By utilizing the patient's own chondrocytes, our proposed method may broaden the choice of implant materials while minimizing side effects and immune reaction for the future medical application.
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Affiliation(s)
- Dong Joon Lee
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, CB #7454, Chapel Hill, NC 27599, USA; (J.K.); (Y.-I.K.); (Y.H.K.); (S.M.)
- Correspondence: (D.J.L.); (H.W.S.); Tel.: +1-(919)-214-1508 (D.J.L.); +1-(919)-966-8175 (H.W.S.)
| | - Jane Kwon
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, CB #7454, Chapel Hill, NC 27599, USA; (J.K.); (Y.-I.K.); (Y.H.K.); (S.M.)
| | - Yong-Il Kim
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, CB #7454, Chapel Hill, NC 27599, USA; (J.K.); (Y.-I.K.); (Y.H.K.); (S.M.)
- Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Geumoro 20, Mulgeum, Yangsan 50612, Korea
| | - Yong Hoon Kwon
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, CB #7454, Chapel Hill, NC 27599, USA; (J.K.); (Y.-I.K.); (Y.H.K.); (S.M.)
- Department of Dental Materials, Pusan National University, Busandaehak-ro 49, Mulgeum, Yangsan 50612, Korea
| | - Samuel Min
- Oral and Craniofacial Health Science Institute, School of Dentistry, University of North Carolina, CB #7454, Chapel Hill, NC 27599, USA; (J.K.); (Y.-I.K.); (Y.H.K.); (S.M.)
| | - Hae Won Shin
- Department of Neurology, School of Medicine, University of North Carolina, CB #7025, Chapel Hill, NC 27599, USA
- Correspondence: (D.J.L.); (H.W.S.); Tel.: +1-(919)-214-1508 (D.J.L.); +1-(919)-966-8175 (H.W.S.)
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18
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Mohs Micrographic Surgery for the Treatment of External Ear Melanoma: an Outcome Study. Dermatol Surg 2019; 46:995-1003. [DOI: 10.1097/dss.0000000000002229] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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19
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Guliani A, Razmi TM, Vinay K, Aggarwal D. Split Plaque over Postauricular Area. Indian Dermatol Online J 2019; 10:490-491. [PMID: 31334083 PMCID: PMC6615383 DOI: 10.4103/idoj.idoj_494_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ankur Guliani
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - T Muhammed Razmi
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Keshavamurthy Vinay
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Divya Aggarwal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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20
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Lee SY, Lee HG, Kim KS, Hwang JH. A rare development of tumoral calcinosis of the ear auricle. Arch Craniofac Surg 2018; 19:287-290. [PMID: 30613092 PMCID: PMC6325332 DOI: 10.7181/acfs.2018.02306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 11/20/2018] [Indexed: 11/11/2022] Open
Abstract
Tumoral calcinosis is a condition characterized by deposition of calcium salts in the skin and sub- cutaneous tissue, commonly found around the joints. However, tumoral calcinosis of the auricle is extremely rare. We present the case of a 13-year-old boy with tumoral calcinosis of the helix of the ear auricle. A 13-year-old boy presented with a 10-year history of an enlarging mass on the left auricle. The mass was hard, non-tender, and non-compressible. The patient had no history of trauma. Complete surgical excision and pathological examination of the specimen was performed. The final diagnosis of the excised mass was tumoral calcinosis. After 9 months of follow-up, there were no signs of recurrence of the tumor and the patient was satisfied with the surgical results. Tumoral calcinosis of the auricle is extremely rare and may be misdiagnosed as other tumors. Pathological examination is essential for definitive diagnosis and complete surgical excision should be considered as the treatment of choice.
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Affiliation(s)
- Sam Yong Lee
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Han Gyeol Lee
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Kwang Seog Kim
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
| | - Jae Ha Hwang
- Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea
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21
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Kim JK, Bae IH, Kim MS, Choi H, Na CH, Shin BS. A Study of Skin Disease of the External Ear in Older Adults According to Anatomical Location. Ann Geriatr Med Res 2018; 22:88-93. [PMID: 32743252 PMCID: PMC7387616 DOI: 10.4235/agmr.2018.22.2.88] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 05/08/2018] [Accepted: 05/30/2018] [Indexed: 11/29/2022] Open
Abstract
Background Due to its anatomical location, the external ear is easily exposed and damaged due to trauma, weathering, and inflammation. Therefore, depending on the patient’s age, different cutaneous diseases can occur. In addition, because of its small percentage of the overall body area, patients and doctors may miss observing dermatologic diseases of the ear. The purpose of this study was to provide information on the most common dermatologic diseases according to the location on the external ear. Methods This retrospective study was conducted on patients who visited the Department of Dermatology of Chosun University Hospital in the past 7 years. Results We included 269 patients and categorized their ear lesions according to 8 anatomical locations and 5 types of dermatologic diseases. In older patients over 60 years of age, the most common site of dermatologic disease was the postauricular region (33.9%), followed by the antihelix (19.4%), and earlobe (12.9%). The most common dermatologic disease was benign tumor (53.2%), followed by malignant and premalignant tumors (32.3% and 9.7%, respectively). Conclusion The proportion of older adults with premalignant and malignant diseases was relatively high and these were most commonly observed in the antihelix and postauricular area. Therefore, it is important to aware the need for the examination, diagnosis, and treatment of disease in the antihelix and postauricular area.
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Affiliation(s)
- Jong Kyu Kim
- Department of Neurosurgery, Chosun University Medical School, Gwangju, Korea
| | - In Ho Bae
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - Min Sung Kim
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - Hoon Choi
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - Chan Ho Na
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
| | - Bong Seok Shin
- Department of Dermatology, Chosun University Medical School, Gwangju, Korea
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22
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Richards LE, Samie F, Troob S, Lewin JM. The use of a tympanoplasty blade for tumor extirpation of the auricle. J Am Acad Dermatol 2018; 80:e121-e122. [PMID: 29969698 DOI: 10.1016/j.jaad.2018.06.041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 06/26/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Lindsey E Richards
- Columbia University Irving Medical Center, Dermatology, New York, New York
| | - Faramarz Samie
- Columbia University Irving Medical Center, Dermatology, New York, New York
| | - Scott Troob
- Columbia University Irving Medical Center, Dermatology, New York, New York
| | - Jesse M Lewin
- Columbia University Irving Medical Center, Dermatology, New York, New York.
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23
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Abstract
Reconstruction of partial ear defects represents one of the most challenging areas within reconstructive surgery of the head and neck. Each case of auricular reconstruction is unique and warrants a systematic approach that accounts for defect size and location, the quality of the surrounding skin, patient preference, and operator experience. In this article, the authors outline different reconstructive approaches for defects of the upper-, middle-, and lower-third of the auricle. The relevant anatomy is discussed in detail. Successful outcomes in auricular reconstruction rely on the surgeon's careful analysis of the defect as well as knowledge of the different reconstructive options available.
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Affiliation(s)
- Brent B Pickrell
- Division of Plastic Surgery, Harvard Medical School, Boston, Massachusetts
| | | | - Renata S Maricevich
- Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
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24
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Deshpande NS, Sen A, Vasudevan B, Neema S. Acanthoma Fissuratum: Lest we Forget. Indian Dermatol Online J 2017; 8:141-143. [PMID: 28405560 PMCID: PMC5372440 DOI: 10.4103/2229-5178.202267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Nikhil S Deshpande
- Department of Pathology, Diamond Jubilee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Arijit Sen
- Department of Pathology, Diamond Jubilee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Biju Vasudevan
- Department of Dermatology, Diamond Jubilee Block, Armed Forces Medical College, Pune, Maharashtra, India
| | - Shekhar Neema
- Department of Dermatology, Diamond Jubilee Block, Armed Forces Medical College, Pune, Maharashtra, India
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25
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Goder M, Kornhaber R, Bordoni D, Winkler E, Haik J, Tessone A. Cutaneous basal cell carcinoma arising within a keloid scar: a case report. Onco Targets Ther 2016; 9:4793-6. [PMID: 27536142 PMCID: PMC4976908 DOI: 10.2147/ott.s113724] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Basal cell carcinomas (BCCs) are one of the most frequent cutaneous malignancies. The majority of BCCs are reported to occur on the auricular helix and periauricular region due to ultraviolet light exposure. Despite the frequency of BCCs, those that develop within scar tissue are rare, and the phenomenon of keloid BCCs has rarely been reported in the literature. Keloid collagen within BCCs is associated with morphoeiform characteristics, ulceration, or necrosis. Extensive keloid collagen is often seen in BCCs of the ear region, a site prone to keloid scarring. This article presents a rare case of a secondary tumor (BCC) which arose on top of a primary tumor (keloid scar) on the right auricle region in a healthy 23-year-old female after an ear piercing 2 years prior. To our knowledge, the tumor described in this case, in contrast to keloidal BCCs, has never been reported in the literature.
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Affiliation(s)
- Maya Goder
- Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Rachel Kornhaber
- School of Health Sciences, Faculty of Health, University of Tasmania, Sydney, NSW, Australia
| | - Daniele Bordoni
- Department of Senology, Ospedale Santa Maria della Misericordia Urbino, Urbino, Italy
| | - Eyal Winkler
- Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Josef Haik
- Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel
| | - Ariel Tessone
- Department of Plastic and Reconstructive Surgery, Sheba Medical Center, Tel Hashomer, Israel
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26
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Assessment of Patients Who Underwent Nasal Reconstruction After Non-Melanoma Skin Cancer Excision. J Craniofac Surg 2016; 26:1299-303. [PMID: 26080180 DOI: 10.1097/scs.0000000000001563] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Basal and squamous cell carcinomas are the most common malignant cutaneous lesions affecting the nose. With the rising incidence of skin cancers, plastic surgeons increasingly face nasal reconstruction challenges. Although multiple options exist, optimal results are obtained when "like is used to repair like". We aimed to introduce a simple algorithm for the reconstruction of nasal defects with local flaps, realizing that there is always more than one option for reconstruction. PATIENTS AND METHODS We retrospectively reviewed 163 patients who underwent nasal reconstruction after excision of non-melanoma skin cancer between March 2011 and April 2014. We analyzed the location of the defects and correlated them with the techniques used to reconstruct them. RESULTS There were 66 males and 97 females (age, 21-98 years). Basal cell carcinoma was diagnosed in 121 patients and squamous cell carcinoma in 42. After tumor excision, all the defects were immediately closed by either primary closure or local flap options such as Limberg, Miter, glabellar, bilobed, nasolabial, V-Y advancement, and forehead flaps. CONCLUSIONS Obtaining tumor-free borders and a pleasing aesthetic result are major concerns in nasal reconstruction. Defect reconstruction and cosmesis are as important as rapid recovery and quick return to normal daily activities, and these should be considered before performing any procedure, particularly in elderly patients.
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Gong Y, Labh S, Jin Y, Diao HY, Li XL, Liu ZY, Shi YL. Needle-free injection of 5-aminolevulinic acid in photodynamic therapy for the treatment of non-melanoma skin cancer. Dermatol Ther 2016; 29:255-62. [PMID: 26811297 DOI: 10.1111/dth.12335] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Yu Gong
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Sony Labh
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Yi Jin
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Hong-Yue Diao
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Xiu-Li Li
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Zhi-Yu Liu
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
| | - Yu-Ling Shi
- Department of Dermatology; Shanghai Tenth People's Hospital, Tongji University School of Medicine; Shanghai China
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Ebrahimi A, Kazemi A, Rasouli HR, Kazemi M, Kalantar Motamedi MH. Reconstructive Surgery of Auricular Defects: An Overview. Trauma Mon 2015; 20:e28202. [PMID: 26839867 PMCID: PMC4727475 DOI: 10.5812/traumamon.28202] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 02/24/2015] [Indexed: 11/21/2022] Open
Abstract
Context: Despite the ongoing advances in surgical procedures and promising progress in bioengineering techniques, auricular reconstruction remains a significant challenge in plastic surgery. There are different causes for acquired auricular defects, including trauma, tumor ablation and burns. The management options for upper, middle and lower third auricular defects are briefly reviewed in the current paper. Evidence Acquisition: Original research papers investigating the plastic surgeons, otolaryngologists and maxillofacial surgeons in approaching the complicated issue of auricular reconstruction published from January 1995 to December 2014 were aggregated and used in the current study. Results: Utilizing autologous stem cell populations to treat craniofacial defects is a promising field of ongoing investigations. Studies show that cartilage stem/progenitor cells (CSPCs) are highly chondrogenic and can produce elastic reconstructive material with long-term tissue restoration. Conclusions: Auricular reconstruction surgery is a challenging plastic procedure that requires great expertise and expert knowledge of the various techniques available. Novel techniques in the fields of reconstructive bioengineering and regenerative medicine are promising but further research is required before widespread clinical application.
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Affiliation(s)
- Ali Ebrahimi
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Alireza Kazemi
- Education Development Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Hamid Reza Rasouli
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Maryam Kazemi
- Education Development Center, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Hosein Kalantar Motamedi
- Trauma Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Mohammad Hosein Kalantar Motamedi, Trauma Research Center, Baqiyatallah University of Medical Sciences, P. O. Box: 19647, Tehran, IR Iran. Tel: +98-2122616946, Fax: +98-2188053766, E-mail:
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De Sousa RF, Chakravarty B, Sharma A, Parwaz MA, Malik A. Efficacy of triple therapy in auricular keloids. J Cutan Aesthet Surg 2014; 7:98-102. [PMID: 25136210 PMCID: PMC4134660 DOI: 10.4103/0974-2077.138347] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Keloids are characterised by their continued growth following trauma, extension into normal tissue and their high recurrence rate following excision. Auricular keloids are common following ear piercing or flame burns. These lesions are highly conspicuous and cosmetically unappealing. Multiple methods including surgery, radiotherapy, antimitotic agents, silicone sheet, pressure clips and cryotherapy have been advocated. The risk of recurrence and the need to prevent distortion of the three-dimensional structure of the ear following resection is a challenge to the cutaneous surgeon. OBJECTIVES To devise a standard protocol for management of auricular keloids with minimal distortion and recurrence. SETTING AND DESIGN The patients underwent day-care surgery and subsequent out-patient follow-up for a minimum period of 1 year. METHODS Ten patients presenting with 22 ear keloids were enrolled into a keloid protocol: (a) surgical excision and keloid rind flap cover with (b) intra-operative and post-operative intra-lesional steroid and (c) silicone sheet application. Subjective assessment on follow-up was using Patient Observer Scar Assessment Scale and objective assessment was by Beausang scale. STATISTICAL ANALYSIS USED Microsoft Excel and Statistical Package for the Social Sciences (SPSS). Kaplan-Meier survival analysis curve used to calculate Recurrence Free period. RESULTS Two out of 22 (9.1%) keloids developed post-excision recurrence after a mean follow -up period of 16 months. The average keloid recurrence free interval was 21 months. CONCLUSION Triple combination therapy for keloids on the ear is a simple technique for management with preservation of contour of the ear and a low recurrence rate.
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Affiliation(s)
- Reuben F De Sousa
- Department of Plastic Surgery, Armed Forces Medical College, Pune, Maharashtra, India
| | - Bijitesh Chakravarty
- Department of Plastic Surgery, Armed Forces Medical College, Pune, Maharashtra, India
| | - Alok Sharma
- Department of Plastic Surgery, Armed Forces Medical College, Pune, Maharashtra, India
| | - M Alam Parwaz
- Department of Plastic Surgery, Armed Forces Medical College, Pune, Maharashtra, India
| | - Anil Malik
- Department of Plastic Surgery, Armed Forces Medical College, Pune, Maharashtra, India
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31
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Reconstruction of External Auditory Canal With a Laterocervical Twisted (Snail) Flap. J Craniofac Surg 2013; 24:e224-6. [DOI: 10.1097/scs.0b013e318286994a] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Mazzoni C, Mangiapelo E, Palermo V, Falcone C. Hypothesis: is yeast a clock model to study the onset of humans aging phenotypes? Front Oncol 2012; 2:203. [PMID: 23293770 PMCID: PMC3533236 DOI: 10.3389/fonc.2012.00203] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2012] [Accepted: 12/11/2012] [Indexed: 12/19/2022] Open
Abstract
In this paper we report the growth and aging of yeast colonies derived from single cells isolated by micromanipulation and seeded one by one on separated plates to avoid growth interference by surrounding colonies. We named this procedure clonal life span, and it could represent a third way of studying aging together with the replicative life span and chronological life span. In this study we observed over time the formation of cell mass similar to the human “senile warts” (seborrheic keratoses), the skin lesions that often appear after 30 years of life and increase in number and size over the years. We observed that similar signs of aging appear in yeast colonies after about 27 days of growth and increase during aging. In this respect we hypothesize to use yeast as a clock to study the onset of human aging phenotypes.
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Affiliation(s)
- Cristina Mazzoni
- Department of Biology and Biotechnology "Charles Darwin", University of Rome "La Sapienza" Rome, Italy ; Pasteur Institute-Cenci Bolognetti Foundation, University of Rome "La Sapienza" Rome, Italy
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Sand M, Sand D, Thrandorf C, Paech V, Altmeyer P, Bechara FG. Cutaneous lesions of the nose. Head Face Med 2010; 6:7. [PMID: 20525327 PMCID: PMC2903548 DOI: 10.1186/1746-160x-6-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Accepted: 06/04/2010] [Indexed: 12/31/2022] Open
Abstract
Skin diseases on the nose are seen in a variety of medical disciplines. Dermatologists, otorhinolaryngologists, general practitioners and general plastic and dermatologic surgeons are regularly consulted regarding cutaneous lesions on the nose. This article is the second part of a review series dealing with cutaneous lesions on the head and face, which are frequently seen in daily practice by a dermatologic surgeon. In this review, we focus on those skin diseases on the nose where surgery or laser therapy is considered a possible treatment option or that can be surgically evaluated.
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Affiliation(s)
- Michael Sand
- Department of Dermatology and Allergology, Dermatologic Surgery Unit, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany
| | - Daniel Sand
- Case Western Reserve University, School of Medicine, 10900 Euclid Avenue, Cleveland, Ohio 44106, USA
| | - Christina Thrandorf
- Department of Dermatology and Allergology, Dermatologic Surgery Unit, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany
| | - Volker Paech
- Department of Dermatology and Allergology, Dermatologic Surgery Unit, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany
| | - Peter Altmeyer
- Department of Dermatology and Allergology, Dermatologic Surgery Unit, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany
| | - Falk G Bechara
- Department of Dermatology and Allergology, Dermatologic Surgery Unit, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany
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