1
|
Sharma RK, DeSisto NG, Longino ES, Stephan SJ, Patel PN, Yang SF. Postoperative Cosmetic Scores and Revision Rates After Nasal Mohs Reconstructive Surgery. Otolaryngol Head Neck Surg 2024; 171:693-701. [PMID: 38738913 DOI: 10.1002/ohn.811] [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: 12/17/2023] [Revised: 04/09/2024] [Accepted: 04/19/2024] [Indexed: 05/14/2024]
Abstract
OBJECTIVE Few studies have examined the impact of preoperative and surgical factors on the change in cosmetic survey scores after nasal Mohs reconstruction using a subset of the 10-item Standardized Cosmesis and Health Nasal Outcomes Survey-Cosmesis (SCHNOS-C). We aim to determine preoperative and surgical factors that impact cosmetic outcomes following Mohs nasal reconstruction. STUDY DESIGN Retrospective analysis. SETTING Nasal Mohs reconstruction patients at a tertiary medical center. METHODS All patients receiving Mohs reconstruction of any nasal subunit at a tertiary medical center were analyzed. Variables collected included demographic and Mohs defect/reconstruction characteristics. Primary outcomes were changes in cosmetic (SCHNOS-C) scores and revision rates. Multivariable analysis was used to identify independent predictors of cosmetic scores/revision. RESULTS We included 296 patients for analysis. On multivariable logistic regression, factors contributing to better final cosmetic scores were receiving a skin/composite graft (odds ratio [OR]: 0.22, 95% confidence interval: 0.06-0.68, P = .014) compared to a local flaps. Women were more likely to have worsening cosmetic scores (OR: 2.27, 1.06-4.99, P = .037). Only initial cosmetic scores independently predicted receiving any revision (OR: 1.11, 1.03-1.20, P = .006). CONCLUSION Average SCHNOS-C scores after nasal reconstruction of Mohs defects are low. Only worse patient reported SCHNOS-C scores predicted revision. It is important to understand preoperative and surgical factors that affect cosmetic outcomes to optimize patient counseling and reconstructive planning. Patient perception is a key factor in predicting revisions.
Collapse
Affiliation(s)
- Rahul K Sharma
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Nicole G DeSisto
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Elizabeth S Longino
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Scott J Stephan
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Priyesh N Patel
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Shiayin F Yang
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| |
Collapse
|
2
|
Kamrani P, Boen M, Zubair R, Dayan SH, Fabi SG. A Review of Neuromodulators and Energy-Based Devices for Optimizing Nasal Appearance. Facial Plast Surg Aesthet Med 2024. [PMID: 38946551 DOI: 10.1089/fpsam.2023.0316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/02/2024] Open
Abstract
Importance: The demand for less invasive nasal procedures has been increasing, highlighting a gap in research on alternatives beyond fillers. This review explores the potential of neuromodulators and energy-based devices for nonsurgical rhinoplasty. Observations: Both botulinum toxin and energy-based devices used independently or alongside fillers have been studied for nasal shape adjustments. Neuromodulator injection of the depressor septi nasi can reduce nasal tip droop, which can reduce the appearance of a plunged nose. Treatment of the dilator naris can minimize alar flaring, giving the appearance of a thinner nasal tip. These methods primarily reported patient-reported outcomes. Energy-based devices have been used to address nasal skin quality and shape contouring, including resurfacing devices for rhinophyma with improvement in both physician and patient-reported outcomes. The 1470 nm laser achieved nasal reshaping after two sessions. Radiofrequency microneedling was notable for volumetric reduction in the nose (excluding nasal tip), confirmed by 3D imaging, lasting about 12 months. Conclusions and Relevance: The use of neuromodulators and energy-based devices may offer promising results for nasal reshaping. However, there is a need for further comparison studies using both objective measures such as 3D photography and physician and patient-reported outcomes, prior to establishing best practices for these techniques.
Collapse
Affiliation(s)
- Payvand Kamrani
- Department of Dermatology, Penn State Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Monica Boen
- Cosmetic Laser Dermatology, San Diego, California, USA
| | - Raheel Zubair
- Cosmetic Laser Dermatology, San Diego, California, USA
| | | | - Sabrina G Fabi
- Cosmetic Laser Dermatology, San Diego, California, USA
- University of California, San Diego CA, USA
| |
Collapse
|
3
|
Bascone CM, Deitermann A, Lin SK, McGraw JR, Raj LK, Nugent ST, Wang L, Broach RB, Miller CJ, Kovach SJ. Using Integra for Reconstruction of Facial Defects after Mohs Micrographic Surgery. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2023; 11:e5474. [PMID: 38111719 PMCID: PMC10727678 DOI: 10.1097/gox.0000000000005474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 10/18/2023] [Indexed: 12/20/2023]
Abstract
Background We aimed to identify how Integra bilayer wound matrix has expanded facial reconstruction options after Mohs surgery due to its reliability in both single- and dual-stage reconstruction. Methods A retrospective review of patients undergoing Mohs surgery and alloplastic facial reconstruction with Integra between 2012 and 2022 was performed. Patients who underwent single-stage reconstruction and dual-stage reconstruction with skin graft with at least 90 days of follow-up were included. Results One hundred thirty patients with a median age of 76 years were included. Basal cell carcinoma was the most common malignancy (39%). One hundred forty-two lesions were treated and reconstructed same-day with Integra. Lesions most commonly involved the nose (34%) and forehead (22%). The mean postoperative defect size was 26.9 cm2. An estimated 45.5% (n = 60) of defect sites underwent single-stage reconstruction with healing by secondary intention, whereas 54.5% (n = 72) underwent dual-stage reconstruction with skin graft. Integra success rate was 90.2%. Average time to re-epithelialization was 32.2 + 7.3 days. Average time to repigmentation was 169.5 + 14.6 days. The complication rate was 12.8% (n = 17), with 12 undergoing debridement, three needing new Integra graft, and seven needing new skin grafts. Average size for successful healing without complication was 26.6 cm2. Nineteen sites (13.2%) underwent aesthetic improvement procedures, with the majority occurring after dual-stage reconstruction (n = 13). Conclusions Integra is a reliable outpatient reconstructive option for facial Mohs defects that can increase the threshold for autologous tissue harvesting and successfully reconstruct large defects of 26.6 cm2 on average with low complication and reoperation rates.
Collapse
Affiliation(s)
- Corey M. Bascone
- From the Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Annika Deitermann
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pa
| | - Stephanie K. Lin
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pa
| | - J. Reed McGraw
- From the Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa
| | - Leela K. Raj
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pa
| | - Shannon T. Nugent
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pa
| | - Leo Wang
- Department of Dermatology, University of Pennsylvania, Philadelphia, Pa
| | - Robyn B. Broach
- From the Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa
| | | | - Stephen J. Kovach
- From the Department of Surgery, Division of Plastic Surgery, University of Pennsylvania, Philadelphia, Pa
| |
Collapse
|
4
|
Chlebicka I, Stefaniak AA, Janczura K, Wójcik E, Matusiak Ł, Bieniek A, Szepietowski J. Basal cell carcinoma and rosacea: coincidence or relationship? Postepy Dermatol Alergol 2023; 40:642-646. [PMID: 38028413 PMCID: PMC10646708 DOI: 10.5114/ada.2023.130523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 06/06/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The relationship between rosacea and basal cell carcinoma (BCC) is still not known. Almost all reports questioning the relation between BCC and rosacea are focused on rhinophyma. Aim To examine the possible connection of BCC and rosacea. Material and methods 110 patients with BCC located on the face treated surgically in the Dermatosurgery Unit in 2020-2021 were included in the study. A trained dermatologist assessed the presence or absence of concomitant rosacea and assessed its severity according to the Investigator's Global Assessment (IGA). Results Fifty-one (46.4%) subjects with BCC and concomitant clinically diagnosed rosacea were found. In our group 35.5% of women had BCC located on the cheeks, while in men most cancers were located on the nose (55%, n = 11), however this difference has not reached statistical significance. Conclusions The incidence of rosacea in our population was undoubtedly higher, comparing to the normative population. Both rosacea and BCC share the same risk factors - UV exposure, the potential association should not be neglected.
Collapse
Affiliation(s)
- Iwona Chlebicka
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Aleksandra A Stefaniak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Kevin Janczura
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Ewa Wójcik
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Łukasz Matusiak
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Andrzej Bieniek
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - Jacek Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| |
Collapse
|
5
|
Eckardt J, Aebischer V, Häfner HM, Kofler L, Pietschke K, Forchhammer S. [An erythematous nodule on the nasal tip]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2022; 73:659-662. [PMID: 34918179 DOI: 10.1007/s00105-021-04925-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/24/2021] [Indexed: 12/13/2022]
Affiliation(s)
- Julia Eckardt
- Klinik für Dermatologie, Venerologie und Allergologie, Charité Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland. .,Universitäts-Hautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland.
| | - Valentin Aebischer
- Universitäts-Hautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - Hans-Martin Häfner
- Universitäts-Hautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - Lukas Kofler
- Universitäts-Hautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - Katharina Pietschke
- Universitäts-Hautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| | - Stephan Forchhammer
- Universitäts-Hautklinik Tübingen, Liebermeisterstr. 25, 72076, Tübingen, Deutschland
| |
Collapse
|
6
|
Abstract
Early identification of cutaneous manifestations of alcohol and illicit drug use can aid in the diagnosis and management of these uses, as well as their sequelae. In addition, the effects of alcohol and illicit drug use on the skin can result in significant morbidity. Alcohol misuse can present with jaundice, pruritus, pigmentary alterations, urticaria, hair and nail changes, and oral changes. It is also a risk factor for skin cancer and infections. Vascular disturbances associated with alcohol misuse include telangiectasias, palmar erythema, caput medusae, and flushing. Diseases related to alcohol misuse include nutritional deficiencies, porphyria cutanea tarda, psoriasis, seborrheic dermatitis, nummular dermatitis, and rosacea. Other conditions seen in alcohol misuse include Dupuytren contracture, Peyronie disease, and pancreatitis. Dermatologists should also be aware of hepatotoxic medications that are commonly prescribed for skin diseases so as to avoid initiating hepatoxicity in patients who use alcohol. Illicit drug use can manifest with cutaneous fibrosis, scarring, granulomas, ulceration, pruritus, infections, cocaine-levamisole-induced vasculitis, tooth decay, and oral disease. By recognizing the cutaneous stigmata of alcohol and illicit drug use, dermatologists can aid in the identification and treatment of patients suffering from these addictions.
Collapse
Affiliation(s)
- Neelesh P Jain
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Kimberly Shao
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Campbell Stewart
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
| |
Collapse
|
7
|
Sahoo SR, Sarma M. Papillary Carcinoma: A Rare Cause Of Cutaneous Lesion on Dorsum of Nose. ANNALS OF THE NATIONAL ACADEMY OF MEDICAL SCIENCES (INDIA) 2021. [DOI: 10.1055/s-0041-1736504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
AbstractThe skin of the nose is a common site for various benign and malignant lesions. Herein, we report a cutaneous nodular lesion on the dorsum of the nose in an 80-year-old female, which was surgically excised under local anesthesia. On histopathological examination, she was diagnosed with papillary carcinoma, a very rare disorder at such a location. The patient was followed-up and no recurrence was noted.
Collapse
Affiliation(s)
- Soumick Ranjan Sahoo
- ENT Department, ESIC Model Hospital, Guwahati, India
- Guwahati Neurological Research Centre Hospital, Guwahati, India
| | - Mandira Sarma
- ENT Department, ESIC Model Hospital, Guwahati, India
| |
Collapse
|
8
|
Zhao B, Chen L, Liao J, Xie Z, Lei X, Shen Z. Update of Clown Nose-Like Lesion, a Underrecognized Manifestation of Metastatic Malignancies and Genetic Cancer Predisposition Syndromes. Front Med (Lausanne) 2021; 8:673336. [PMID: 34055844 PMCID: PMC8155271 DOI: 10.3389/fmed.2021.673336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 04/12/2021] [Indexed: 11/29/2022] Open
Abstract
Clown nose-like lesion refers to the manifestation of a reddish or skin-colored bulge on the tip of the nose or the manifestation of bulbous tip of the nose. More and more clinical cases show that clown nose-like lesion can also be the indication of some genetic syndromes, not just the manifestation of metastatic visceral tumor as it initially proposed. However, the clinical features of clown nose-like lesion indicated by metastatic malignancies, genetic cancer predisposition syndromes or primary diseases involving the nasal tip are lacking. In this study, patients with clown nose-like lesion in our clinical practices and from published literatures were collected and reviewed. We found that clown nose-like lesions caused by metastatic malignancies including lung cancer are often solitary and more common in male (24/31) older individuals (average age 62.3, ranging 40–78 years old). In addition, they usually appear for a short time, and are prone to be misdiagnosed as primary nasal diseases, leading to a poor prognosis (all patients with data available died within 4 months). Clown nose-like lesions associated with genetic cancer predisposition syndromes usually develop at a young age (mean age 15.3) with female preference (9/10). They are accompanied by multiple-systemic involvements, including low hair volume, developmental delay, cancer predisposition or neurological diseases. They show slow development and often positive family history (6/10). These two kinds of clown nose-like lesions are often asymptomatic, which delays the diagnosis and treatment of underlying malignancies or syndromes. In brief, the term of clown nose-like lesion is underrecognized, and should be updated. Clown nose-like lesions can serve as indicators to at least three categories of clinical issues: metastatic visceral tumors, genetic syndromes, and primary diseases involving the nasal tip. Increased awareness of clinical features of updated clown nose-like lesions can alert physicians to these underlying malignancies or syndromes, render earlier detection of associated medical issues, and allow for genetic counseling of family members.
Collapse
Affiliation(s)
- Bei Zhao
- Department of Dermatology, Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Ling Chen
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing, China
| | - Jinfeng Liao
- Department of Dermatology, Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Zhen Xie
- Department of Dermatology, Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China
| | - Xia Lei
- Department of Dermatology, Daping Hospital, Army Medical University, Chongqing, China
| | - Zhu Shen
- Department of Dermatology, Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, China.,School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| |
Collapse
|
9
|
SAKTHİVEL S, BABU GS, CASTELİNO R, AJİLA V, BİSWAS A. Bir Auriküler Keloid Olgusu Sunumu. KOCAELI ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2020. [DOI: 10.30934/kusbed.658867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
10
|
Large Rhinophyma Treated by Surgical Excision and Electrocautery. Case Rep Surg 2019; 2019:2395619. [PMID: 31428506 PMCID: PMC6683787 DOI: 10.1155/2019/2395619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/20/2019] [Indexed: 12/23/2022] Open
Abstract
Rhinophyma is a benign condition characterized by a large, bulbous nose with prominent pores. It is commonly associated with untreated cases of rosacea. The disease can carry a substantial psychological impact that causes patients to seek advice about how to improve their physical appearance. Many treatment options are available for rhinophyma, but there is no standard treatment protocol. Here, we describe the case of a 65-year-old man with a large rhinophyma that caused him cosmetic and psychosocial embarrassment. The condition was treated by surgical excision and bipolar electrocautery. No complications occurred after the procedures, and healing was completed 2 weeks later by secondary intention and reepithelialization. A simple surgical removal using a scalpel to shave off the abnormal tissue with electrocauterization of the bleeding points can be considered as a good treatment option for rhinophyma, as it results in an excellent cosmetic outcome and has short recovery time.
Collapse
|
11
|
Geyton T, Henderson AH, Morris J, McDonald S. Nasal tip schwannoma mimicking rhinophyma. BMJ Case Rep 2017; 2017:bcr-2017-223495. [PMID: 29269374 DOI: 10.1136/bcr-2017-223495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Thomas Geyton
- Department of ENT Surgery, Royal United Hospitals NHS Trust, Bath
| | | | - James Morris
- Department of ENT Surgery, Royal United Hospitals NHS Trust, Bath
| | - Steve McDonald
- Department of ENT Surgery, Royal United Hospitals NHS Trust, Bath
| |
Collapse
|
12
|
Keratoacanthoma of the Nasal Septum Secondary to Ranibizumab Use. Case Rep Pathol 2017; 2017:8257590. [PMID: 28584672 PMCID: PMC5443992 DOI: 10.1155/2017/8257590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 04/27/2017] [Indexed: 11/17/2022] Open
Abstract
Keratoacanthoma (KA) is a benign epithelial tumor that typically presents as a firm, cone-shaped, flesh-colored nodule with a central horn-filled crater. KA is considered to be a low-grade variant of squamous cell carcinoma (SCC). We report a rare case of a 72-year-old male who presented with a KA involving the nasal septum, possibly related to ranibizumab use. A flesh-colored lesion on the right anterior nasal septum lesion was visualized on examination. Histologic examination revealed a well-circumscribed, dome-shaped central crater filled with keratin, well-differentiated squamous epithelium with ground-glass cytoplasm with pushing margins, and intraepithelial microabscesses establishing the diagnosis of KA. KA of the nasal septum has only been reported once in the literature. This case is unusual because it normally presents on sun-exposed areas. Additionally, this patient was taking ranibizumab, a vascular endothelial growth factor (VEGF) inhibitor for macular degeneration. Despite ranibizumab not being directly linked to precancerous and cancerous skin lesions, agents in this medication class have been. Although it is difficult to prove associations in this isolated case, the role of ranibizumab causing cutaneous lesions should be further investigated.
Collapse
|
13
|
Abstract
OBJECTIVES The goal of this study was to review the main lesion types of the nasal skin and appropriate treatment strategies rather than to present a comprehensive list of all diseases that affect the skin that can involve the nose. METHODS We reviewed the main nasal skin lesion types and available treatment strategies. Nasal skin lesions were classified as benign, premalignant, or malignant. RESULTS Benign lesions of the nose include nonmalignant tumoral lesions (i.e., freckles, comedo, adenoma sebaceum [Pringle disease], hydrocystoma, fibrous papules, sebaceous hyperplasia, and rhinophyma), autoimmune and inflammatory conditions (i.e., pemphigus, sarcoidosis, systemic lupus erythematosus, facial eosinophilic granuloma, rosacea, herpes zoster infection, leishmaniasis, and leprosy), and vascular lesions (i.e., telangiectasis, hemangioma, and spider nevus). Premalignant lesions are actinic keratosis and keratoacanthoma; and malignant tumors are melanoma, basal cell carcinoma, and squamous cell carcinoma. Regardless of whether or not they are malignant, all facial lesions can yield significant cosmetic discomfort that should be evaluated carefully before commencing any curative or corrective intervention. In general, benign lesions are treated with dermabrasive modalities, such as trichloroacetic acid, phenol, salicylate, and laser ablation. Electrocautery, cryosurgery, and surgical excision are also used, although these methods may result in scar formation, which can sometimes be more problematic than the original lesion itself. CONCLUSION Any disease that affects the skin, especially those diseases that are triggered by ultraviolet exposure, can involve the face and nose. Cosmetic defects due both to the lesion itself and the intervention must be discussed with the patient, preferably in the presence of a first-degree relative, before commencement of treatment. As a result of heterogeneity of skin lesions of the nose, appropriate education of general practitioners as well as otorhinolaryngologists is mandatory.
Collapse
Affiliation(s)
- Ayse Pelin Yigider
- Otorhinolaryngology and Head and Neck Surgery Clinic, Bakirkoy Dr Sadi Konuk Research and Training Hospital, Istanbul, Turkey
| | | | | | | | | |
Collapse
|
14
|
Nasofacial Destruction Due to Rhinoscleroma and Review of Other Causes. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2017. [DOI: 10.1097/ipc.0000000000000454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
15
|
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.
Collapse
|