Fournier's gangrene - case report and a brief review

Fournier's gangrene is a serious condition with very high mortality. It is usually associated with various co-morbidities. Early diagnosis with multispecialty approach and aggressive management is the key to successful outcome. We successfully managed Fournier's gangrene in a 32-year-old diabetic male. This case is reported and the condition is reviewed in the light of recent literature

Familial aplasia cutis congenital

Aplasia cutis is a disorder characterized by developmental absence of portion of skin. Scalp is the most commonly involved site. The etiopathogenesis of the disease is not fully understood and multiple theories have been proposed for explanation. The disorder occurs sporadically and cases with familial occurrence are very rarely mentioned in literature. One such case with familial aplasia cutis of scalp is reported in this article

Chondrodermatitis nodularis chronica helicis - a review

Chondrodermatitis nodularis chronica helicis [CNCH] is a condition characterized by spontaneously evolving tender single or multiple nodules over the apex of helix or antihelix of the external ear. Various factors have been proposed to be the causative agents and different medical /surgical modalities of treatment have been devised. We review this disease in detail and present one such case which was managed on conservative lines.

Complications of dermal fillers - an experience from Middle-East

Dermal fillers have become exceedingly common globally in recent years for body rejuvenation, but with their widespread use and increasing profitability, cases of complications of dermal fillers are being widely reported. To document the complications related to dermal fillers as managed by the authors while working in different hospitals of Riyadh city. Demographic and clinical data of 47 cases, reporting with complications of dermal fillers over a period of two years from June 2009 to June 2011, were analysed. The complications were categorised by a self designed category system based on management and outcome. 44 females and 3 males, ranging in age from 23 years to 62 years were managed for complications of dermal fillers affecting face, hands, buttocks and external genitalia. 83% of cases had moderate to severe complications, and 51% were unaware of the nature of dermal filler received by them. 20 cases [42.5%] required surgical treatment and interventions under anesthesia. With increased use of dermal fillers, the complications are also being frequently encountered. Dermatologists should be wary of these avoidable untoward effects and their proper management

Post clubfoot release skin necrosis: a preventable disaster

Complications of pedal wounds closed primarily after release of neglected cases of club foot are well known in literature. We treated a 12-year-old boy presenting with widespread necrosis involving medial aspect of foot after release of neglected talipes equinovarus. Such widespread necrosis is even known to end up in amputations and permanent disabilities. In our case, the foot was successfully salvaged by resorting to dedicated wound care, multiple debridements, use of topical negative pressure [vacuum-assisted closure [VAC], and skin grafting. Various means to prevent such adverse events are also presented. The aim of publishing this case is to stress the need to: 1. Take proper measures preoperatively in neglected club feet to decrease the impact of deformity. 2. To be aware of various different flaps and methods of closure as mentioned in literature and to reaffirm the fact that primary closures done under tension are bound to fail and end up in disasters. 3. To be patient and use the modern concepts of wound management like topical negative pressure if such unfortunate complications do occur and thereby attempt to salvage the feet

Endometriosis: a rare cause of appendicitis

Endometriosis is a relatively common disorder affecting about 15% females in the reproductive age group. It is a well-known cause of infertility but endometriosis presenting as appendicitis is rare. We present a case of a 29 years old nulliparous lady in whom appendectomy was done for appendicitis and histopathological examination of the retrieved specimen revealed endometriosis

Multiple facial pilomatricomas

Pilomatricoma is a benign and often misdiagnosed tumor arising from hair matrix cells. It is predominantly found in children below the age of 10 years and is characterized histologically by basaloid and eosinoplilic ghost or empty cells. Pilomatricoma is generally solitary and multiple tumors are rarely reported. We report one such rare case of multiple facial pilomatricomas in a one-year-old girl

Digital gangrene in end-stage renal disease

Ischemic complications presenting as digital gangrene occurring in a patient of end-stage renal disease undergoing haemodialysis is rarely reported in literature. We report one such case of dry gangrene of a single finger in a 53 years old male undergoing haemodialysis. The condition was likely a steal phenomenon secondary to the surgical angioaccess for dialysis

Cutaneous mucormycosis in a leukemic patient

Mucormycosis is a fulminant and uncommon fungal infection of skin which mostly occurs in immunocompromised patients. Early diagnosis followed by aggressive debridement and administration of antifungal agents is the key to management. We report primary cutaneous mucormycosis in a 23 years old patient of acute leucocytic leukemia who developed this lesion over volar surface of right forearm at the site of intravenous cannulation during induction phase of chemotherapy. The condition was treated successfully by wide surgical debridement, amphotericin-B, wound care and definitive reconstruction with skin graft

Surgical audit of 86 patients of tm joint bony ankylosis treated at a tertiary care hospital in Srinagar

The authors present a review of 86 patients with bony ankylosis of Temporomandibular joint treated between Jan 1990 and Dec 2005 at a tertiary care referral hospital in Srinagar. Childhood trauma was the leading cause of ankylosis. For initial 50 patients of the series, acrylic spacer was used as interpositional material, and for the rest of patients, silicone block was used. Follow-up evaluation ranged from 14 months to five years [average 31 months]. Recurrence was observed in 5 patients [all in acrylic group]. There was statistically no significant difference in post operative mouth opening and other complications between the two groups. The aim of the study was to analyze the treatment outcome of the patients with TMJ ankylosis

ugly outcome of a cosmetic procedure

Dermal fillers are being widely used for rejuvenation of soft tissues. Though usually safe and effective, a wide range of complications can occur. One such case is presented in which dermal filling of hands by an uncertified practitioner led to an ugly outcome

Missed foreign bodies in the hand: an experience from a center in Kashmir

Penetrating hand injuries are common and improper assessment can result in missed foreign bodies. These bodies can result in a wide range of complications. The aim of our study was to study the profile of patients reporting with missed foreign bodies in the hand. All the cases treated in the Department of Surgery, Sheri Kashmir Institute of Medical Sciences [medical college], Kashmir, for missed foreign bodies in hands from June 2003 to May 2009 were studied retrospectively. A total of 61 cases with missed foreign bodies of different nature were treated over the period of six years. Wooden splinters were the most common foreign bodies missed. Preoperative localization was accomplished with plain radiographs and ultrasonograms. Most of the cases were treated on outpatient basis. Foreign bodies should be suspected and ruled out in all cases of penetrating injuries of hands. Missed foreign bodies need to be removed after proper localization by imaging

Congenital isolated right radial club hand

Congenital radial club hand [RCH] is an uncommon congenital anomaly characterized by various degrees of deficiency along the preaxial or radial side of the extremity. We present one such case of Type 4 congenital isolated RCH who presented to a tertiary care center in the Middle East

Subungeal glomus tumor - a case report

Glomus tumor is a rare benign neoplasm that arises from the neuroarterial structure called a glomus body and accounts for 1% to 2% of soft tissue tumors in the hand. We present a case of a 36-year-old female who was treated for subungal glomus tumour of thumb

Aplasia cutis congenita of the scalp

Aplasia cutis congenita is a rare congenital anomaly characterized by localized or widespread areas of absence of skin. Scalp is the most common area involved. No definite etiology is known and multiple factors have been proposed. Our patient was a five days old male neonate who presented with absence of skin over a wide area of scalp with absent scalp bones. Dura formed the base. The lesion was circular and ulcerative with a size of 12 cms x 11 cms on vertex. Regular wound care was provided