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V-shaped Folded Nasolabial Flap in the Repair of the Anterior Buccal Mucosal Defect. J Craniofac Surg 2023; 34:e108-e111. [PMID: 36857557 DOI: 10.1097/scs.0000000000008803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 04/25/2022] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVE To investigate the efficacy of V-shaped folded nasolabial flap in the repair of small-sized and medium-sized defects of the anterior buccal mucosa. METHODS From March 2019 to December 2021, 9 cases of male patients with anterior buccal mucosal lesions were enrolled in this study. After the lesions were completely excised, the mucosa and part of the buccal mucosal defect were left. A transverse V-shaped folded nasolabial flap was created with the pedicle located at the corner of the mouth and the long axis along the nasolabial fold. The lower part was lifted from the end to the pedicle. Next, from the level of the superficial musculo-aponeurotic system, the upper and lower parts were lifted from the end to the pedicle, and the V-shaped flap was folded and turned over through the buccal tunnel to repair the mucosal defect. The extraoral donor site was directly pulled and sutured. RESULTS The nasolabial flap survived in 9 patients, and the wounds inside and outside the mouth healed at stage I. The postoperative follow-up time was 4 to 32 months, and the patients had no recurrence, with symmetrical buccal shape, and no traction and deformation in the affected buccal organs. In addition, the linear scar had no obvious hyperplasia and was hidden in the affected nasolabial folds, without symptoms of buccal nerve injury, and the shape of the corner of the mouth was normal. The width and opening degree of oral fissure were not significantly reduced compared with those before operation. Meanwhile, the intraoral flap was thin and flat, and healed well with the surrounding mucosa, without obvious flap contracture, buccal bite, or incomplete closure. CONCLUSION Overall, V-shaped folded nasolabial flap has the advantages of flexible design, simple preparation, reliable blood supply, and protection of the donor site, which may be one of the effective methods for repairing small-sized and medium-sized defects in the anterior buccal mucosa.
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Shahwan KT, Mori WS, Bakker C, Mattox AR, Alam M, Maher IA. Reconstruction of Perioral Defects After Mohs Micrographic Surgery or Excision: A Systematic Review of the Literature. Dermatol Surg 2021; 47:162-166. [PMID: 33565771 DOI: 10.1097/dss.0000000000002810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although many repair methods for postsurgical lip defects have been described, the literature lacks a comprehensive review of these methods. OBJECTIVE To perform a systematic review of lip defect repair methods after Mohs surgery or excisions. MATERIALS AND METHODS Terms related to perioral anatomy, Mohs surgery and excision, and reconstruction were used to search 8 databases. Articles were included if they reported postsurgical lip repair data for 4 or more patients, were in English, and were published from 2004 onward. Two reviewers screened all titles and abstracts, followed by the full texts of the remaining articles. Data were then extracted including author specialties, study design, demographic, tumor, and defect information, surgical procedures, outcomes, and complications. RESULTS Forty-two studies were eligible, including a randomized trial, 25 case series, and 16 cohort studies. Most were written by dermatologic or plastic surgeons, and most studies were small, with an average subject number of 61. Very few studies used structured outcome measures. Many repair methods were described, the most common of which were linear closures and various flaps. CONCLUSION Many repair methods for lip defects have been published, but overall, the quality of the available evidence is low.
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Affiliation(s)
- Kathryn T Shahwan
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Westley S Mori
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Caitlin Bakker
- Health Sciences Library, University of Minnesota, Minneapolis, Minnesota
| | - Adam R Mattox
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
| | - Murad Alam
- Department of Dermatology, Northwestern University, Chicago, Illinois
| | - Ian A Maher
- Department of Dermatology, University of Minnesota, Minneapolis, Minnesota
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Goldman A, Wollina U, França K, Lotti T, Tchernev G. Lip Repair after Mohs Surgery for Squamous Cell Carcinoma by Bilateral Tissue Expanding Vermillion Myocutaneous Flap (Goldstein Technique Modified by Sawada). Open Access Maced J Med Sci 2018; 6:93-95. [PMID: 29483995 PMCID: PMC5816329 DOI: 10.3889/oamjms.2018.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/30/2017] [Accepted: 11/30/2017] [Indexed: 12/31/2022] Open
Abstract
Squamous cell carcinoma is the most common malignancy of the lower lip. Environmental factors such as ultraviolet light exposure, arsenic and smoking are contributing factors to the increasing incidence. Mohs surgery is the treatment of choice ensuring the lowest recurrence rates. The closure of the surgical defects, however, can be a challenge. Multiple and versatile methods of reconstructing vermilion defects have been described. Among these options, Goldstein developed the adjacent ipsilateral vermilion flap based on an arterialized myocutaneous flap. The original technique was modified by Sawada based on bilateral adjacent vermilion advancement flap for closure of central vermilion defects. We report the use of bilateral flaps - Sawada’s technique (instead of unilateral as suggested by Goldstein) in medium (2 cm of extension) to large defects (> 2 cm) to achieve an effective and functional reconstruction of vermillion defects after Mohs surgery for lip cancer.
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Affiliation(s)
| | - Uwe Wollina
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Katlein França
- Department of Dermatology and Cutaneous Surgery, Department of Psychiatry & Behavioral Sciences; Institute for Bioethics and Health Policy, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Torello Lotti
- University G. Marconi of Rome - Dermatology and Venereology, Rome, Italy
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, Sofia, Bulgaria.,Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
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Wang F, Ma H, Liu Z, Huang W, Xu X, Zhang X. α-Mangostin inhibits DMBA/TPA-induced skin cancer through inhibiting inflammation and promoting autophagy and apoptosis by regulating PI3K/Akt/mTOR signaling pathway in mice. Biomed Pharmacother 2017; 92:672-680. [PMID: 28582759 DOI: 10.1016/j.biopha.2017.05.129] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2017] [Revised: 04/26/2017] [Accepted: 05/28/2017] [Indexed: 11/19/2022] Open
Abstract
Skin cancer is the most common form of cancer responsible for considerable morbidity and mortality, the treatment progress of which remains slow though. Therefore, studies identifying anti-skin cancer agents that are innocuous are urgently needed. α-Mangostin, a natural product isolated from the pericarp of mangosteen fruit, has potent anti-cancer activity. However, its role in skin cancer remains unclear. The aim of this study was to evaluate the treatment effect of α-mangostin on skin tumorigenesis induced by 9,10-dimethylbenz[a]anthracene (DMBA)/TPA in mice and the potential mechanism. Treatment with α-mangostin significantly suppressed tumor formation and growth, and markedly reduced the incidence rate. α-Mangostin not only inhibited the expressions of pro-inflammatory factors, but also promoted the production of anti-inflammatory factors in tumor and blood. It induced autophagy of skin tumor and regulated the expressions of autophagy-related proteins. The protein expressions of LC3, LC3-II and Beclin1 increased whereas those of LC3-I and p62 decreased after treatment with α-mangostin. Moreover, α-mangostin promoted the apoptosis of skin tumor dose-dependently by up-regulating of Bax, cleaved caspase-3, cleaved PARP and Bad, and down-regulating of Bcl-2 and Bcl-xl. Furthermore, showed α-mangostin inhibited the PI3K/AKT/mTOR (mammalian target of rapamycin) signaling pathway, as evidenced by decreased expressions of phospho-PI3K (p-PI3K), p-Akt and p-mTOR, but did not affect the expressions of t-PI3K, t-Akt or t-mTOR. Collectively, α-mangostin suppressed murine skin tumorigenesis induced by DMBA/TPA through inhibiting inflammation and promoting autophagy and apoptosis by regulating the PI3K/Akt/mTOR signaling pathway, as a potential candidate for future clinical therapy.
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Affiliation(s)
- Fei Wang
- Department of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Hongxia Ma
- Department of Clinical Laboratory Medicine, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Zhaoguo Liu
- Department of Pharmacology, School of Pharmacy, Nantong University, Nantong, 226001, China
| | - Wei Huang
- Department of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China
| | - Xiaojing Xu
- Department of Dermatological, Armed Police Hospital of Shanghai, Shanghai 201103, China
| | - Xuemei Zhang
- Department of Oncology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China.
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Liu Z, Shen C, Tao Y, Wang S, Wei Z, Cao Y, Wu H, Fan F, Lin C, Shan Y, Zhu P, Sun L, Chen C, Wang A, Zheng S, Lu Y. Chemopreventive efficacy of menthol on carcinogen-induced cutaneous carcinoma through inhibition of inflammation and oxidative stress in mice. Food Chem Toxicol 2015; 82:12-8. [PMID: 25956868 DOI: 10.1016/j.fct.2015.04.025] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Revised: 04/16/2015] [Accepted: 04/20/2015] [Indexed: 10/23/2022]
Abstract
Inflammation and oxidative stress have been implicated in various pathological processes including skin tumorigenesis. Skin cancer is the most common form of cancer responsible for considerable morbidity and mortality, the treatment progress of which remains slow though. Therefore, chemoprevention and other strategies are being considered. Menthol has shown high anticancer activity against various human cancers, but its effect on skin cancer has never been evaluated. We herein investigated the chemopreventive potential of menthol against 9,10-dimethylbenz[a]anthracene (DMBA)/12-O-tetradecanoylphorbol-13-acetate (TPA)-induced inflammation, oxidative stress and skin carcinogenesis in female ICR mice. Pretreatment with menthol at various doses significantly suppressed tumor formation and growth, and markedly reduced tumor incidence and volume. Moreover, menthol inhibited TPA-induced skin hyperplasia and inflammation, and significantly suppressed the expression of cyclooxygenase-2 (COX-2). Furthermore, pretreatment with menthol inhibited the formation of reactive oxygen species and affected the activities of a battery of antioxidant enzymes in the skin. The expressions of NF-κB, Erk and p38 were down-regulated by menthol administration. Thus, inflammation and oxidative stress collectively played a crucial role in the chemopreventive efficacy of menthol on the murine skin tumorigenesis.
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Affiliation(s)
- Zhaoguo Liu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Cunsi Shen
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Yu Tao
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Siliang Wang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Zhonghong Wei
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Yuzhu Cao
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Hongyan Wu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Fangtian Fan
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Chao Lin
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Yunlong Shan
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Pingting Zhu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Lihua Sun
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Chen Chen
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China
| | - Aiyun Wang
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China; Jiangsu Key Laboratory for Pharmacolgy and Safety Evaluation of Chinese Materia Medica, Nanjing, Jiangsu 210023, China
| | - Shizhong Zheng
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China; Jiangsu Key Laboratory for Pharmacolgy and Safety Evaluation of Chinese Materia Medica, Nanjing, Jiangsu 210023, China
| | - Yin Lu
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210023, China; Jiangsu Key Laboratory for Pharmacolgy and Safety Evaluation of Chinese Materia Medica, Nanjing, Jiangsu 210023, China.
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Batalla A, Encinas-Muñiz AI, Gutiérrez-González E, de la Mano D. Photoletter to the editor: Basal cell carcinoma on the vermilion lip. J Dermatol Case Rep 2015; 9:25-6. [PMID: 25932061 DOI: 10.3315/jdcr.2015.1195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2013] [Accepted: 12/20/2014] [Indexed: 11/11/2022]
Abstract
The vermilion and vermilion border are rare locations for basal cell carcinoma. We report a case of a 72-year-old woman, who presented with an asymptomatic erosive lesion on the vermilion area of the upper lip. Histopathology examination was consistent with basal cell carcinoma. We suggest that basal cell carcinoma should be included in the differential diagnosis of erosive/ulcerative lesions arising on the vermilion area of the lip.
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Affiliation(s)
- Ana Batalla
- Department of Dermatology, Hospital San Agustín, Avilés, Principado de Asturias, Spain
| | | | | | - Daniel de la Mano
- Department of Dermatology, Hospital San Agustín, Avilés, Principado de Asturias, Spain
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