Reconstruction of perioral defects post-Mohs micrographic surgery: a dermatological surgeon's approach

BACKGROUND

The perioral location has great functional, aesthetic and social importance. Over 100 procedures have been described for lip reconstruction, emphasizing the challenges that reconstructive surgeons face when dealing with such defects.

OBJECTIVES

To outline the surgical reconstruction techniques of perioral defects post-Mohs micrographic surgery (MMS).

METHODS

The design and surgical techniques of reconstruction of perioral defects post-MMS are described.

RESULTS

The results of the surgical techniques described are illustrated.

CONCLUSIONS

Herein, we describe the nuances of reconstructive techniques that we have found useful for repairing perioral defects post-MMS.

Two cases of pustular toxic epidermal necrolysis

Toxic epidermal necrolysis (TEN) is a life-threatening, immune-mediated reaction, characterized by severe cutaneous and mucosal blisters and erosions. It often presents with flu-like symptoms, followed by a maculopapular, urticarial, purpuric or erythema multiforme-like eruption, which then evolves into blisters and sheet-like erosions. Presentation with pustules, however, is not well described in the English literature, and may lead to delayed diagnosis. We present two unusual cases of TEN that initially presented with pustular lesions.