phenylephrine-hydrochloride and Keratosis--Actinic

Like all surgical procedures, dorsal nasal flaps may be followed by both early and late complications. The aim of this study was to evaluate the surgical complications and cosmetic outcome of dorsal nasal flaps over a 7-year period in an academic dermatologic surgery unit.. Data were collected retrospectively for all patients undergoing dorsal nasal flap between 1 January 2006 and 31 December 2013. Early and late complications were recorded. Patients were contacted by phone to assess long-term outcomes.. A total of 35 patients were included. Early complications included bleeding (n=2), local infection (n=2) and focal flap necrosis (n=1). Late complications comprised flap thickening (n=7), restriction of the medial canthus (n=2), opening of the labionasal angle (n=1), stitch granuloma (n=1) and telangiectasia on the flap (n=1). Regarding the aesthetic result, seven patients were very satisfied with the flap. Four patients underwent corrective surgery and one patient had laser treatment for telangiectasia on the flap.. Two thirds of patients were satisfied with the aesthetic results and one third had late complications of the flap. Consequently, patients undergoing Rieger-Marchac procedures must be informed of the potential need for further corrective measures following nasal dorsal flap repair.

Topics: Aged; Aged, 80 and over; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Esthetics; Female; Granuloma; Humans; Keratoacanthoma; Keratosis, Actinic; Male; Middle Aged; Necrosis; Nose; Nose Neoplasms; Patient Satisfaction; Postoperative Hemorrhage; Retrospective Studies; Rhinoplasty; Surgical Flaps; Surgical Wound Infection

Porokeratisis is a specific keratinization disorder. The presence of cornoid lamella is histologically characteristic of the disorder. This report describes a 23-year-old male patient with multiple porokeratotic lesions with bilateral symmetric localization on the ala of the nose, which may be a rare variant of porokeratosis.

Topics: Humans; Keratosis, Actinic; Male; Nose; Porokeratosis; Young Adult

The diagnosis of pigmented actinic keratosis can be complicated in clinical practice. The differential diagnosis with lentigo maligna melanoma can be difficult due to common clinical and dermoscopic characteristics. We present 5 cases of pigmented actinic keratosis in 4 patients. The most common dermoscopic finding was a grayish-brown granulation with a perifollicular distribution, present in all lesions, followed by rhomboidal structures in 4 cases, and an annular-granular pattern in 3. In no case were asymmetrical pigmented follicular openings observed. We draw attention to key findings that aid preoperative diagnosis of pigmented actinic keratosis.

Topics: Aged; Aged, 80 and over; Dermoscopy; Diagnosis, Differential; Epidermis; Facial Dermatoses; Female; Humans; Hutchinson's Melanotic Freckle; Keratinocytes; Keratosis, Actinic; Male; Melanins; Middle Aged; Nose; Skin Pigmentation

Surgical site infections (SSIs) after dermatologic surgery cause pain, prolong healing, result in unaesthetic complications, and lead to excessive use of antibiotics. The pathogenesis of wound infections is complex and is dependent on bacterial load and diversity, among several factors.. To investigate bacterial dynamics at dermatosurgical sites at different time intervals and assess the correlation with postoperative outcomes and to examine different endo- and exogenous factors that may contribute to SSIs.. Eighteen patients undergoing skin grafting of the face were studied. The following SSI-related factors were registered: age and sex of the patient, ulceration of the lesion, diabetes, immunosuppressive therapy, smoking, anticoagulative therapy, and use of antibiotic prophylaxis. Wounds from each patient were swabbed preoperatively, intraoperatively, and postoperatively. The bacterial composition of the swabs was then analyzed quantitatively and qualitatively.. Sixteen of 18 surgical sites contained varying quantities of surface-associated bacteria. Coagulase-negative staphylococci and Propionibacterium acnes were the predominant bacteria isolated at all times. Intraoperative analysis was not predictive of SSIs. Use of antibiotic prophylaxis was the only registered SSI-related factor that showed significant variation in bacterial load between pre- and postoperative samples. Postoperative bacterial load was found to be lower than preoperative load in patients who received antibiotics. This was in contrast to patients who did not receive antibiotics, who had significantly higher postoperative levels (p=.02). The presence of high postoperative bacterial loads, regardless of the bacterial species isolated, showed a statistically significant positive correlation with a complicated postoperative outcome (p≤.001).. This study provides novel insights into the bacterial dynamics of dermatologic surgery-induced wounds and the variation of this over time. The results highlight the potential relevance of quantifying bacterial loads, as well as determining specific types of bacteria, in dermatologic surgery.

Topics: Aged; Aged, 80 and over; Antibiotic Prophylaxis; Bacterial Load; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Cheek; Facial Neoplasms; Female; Floxacillin; Forehead; Humans; Keratosis, Actinic; Male; Middle Aged; Nose; Perioperative Period; Propionibacterium acnes; Skin Neoplasms; Skin Transplantation; Skin Ulcer; Staphylococcus; Surgical Wound Infection; Treatment Outcome