Idiopathic Unilateral Gynecomastia in an Adolescent Male: A Case Report

Gynecomastia refers to persistent enlargement of the breast in males caused by enlargement of the breast bud and surrounding stroma. It typically occurs in newborns, during early adolescence, and in late adulthood. There are several pathological causes. If no pathological cause is evident, gynecomastia is considered idiopathic. The reported prevalence of unilateral gynecomastia is approximately 35% to 45%, but most previous reports have focused on distinctive pathologic causes. As such, few previous reports of idiopathic unilateral gynecomastia during early adolescence have been published. Herein, we report a case of idiopathic unilateral gynecomastia in an adolescent male.

Idiopathic Unilateral Gynecomastia in an Adolescent Male: A Case Report

Gynecomastia refers to persistent enlargement of the breast in males caused by enlargement of the breast bud and surrounding stroma. It typically occurs in newborns, during early adolescence, and in late adulthood. There are several pathological causes. If no pathological cause is evident, gynecomastia is considered idiopathic. The reported prevalence of unilateral gynecomastia is approximately 35% to 45%, but most previous reports have focused on distinctive pathologic causes. As such, few previous reports of idiopathic unilateral gynecomastia during early adolescence have been published. Herein, we report a case of idiopathic unilateral gynecomastia in an adolescent male.

Full Thickness Skin Graft Using Palmar Crease

PURPOSE: The two major concerns in skin grafting are poor color match in the recipient site and the donor site morbidity. And, glabrous skin on the palmar aspect of the hands and plantar aspect of the feet attributes define the skin on the palm and fingers sole as functionally and aesthetically different from skin on other parts of the body. When there is a glabrous skin defect, it should be replaced with similar skin to restore function and aesthetics. The palmar crease areas were used to minimize these problems. The purpose of this study is to present the precise surgical technique of the full thickness skin graft using distal palmar and midpalmar creases for aesthetic better outcome for hand injuries. METHODS: From May 2006 to April 2010, 10 patients with 11 defects underwent glabrous full thickness skin grafting of finger defects. Causes included seven machinery injuries, two secondary burn reconstructions, and one knife injury. Donor sites included ten glabrous full thickness skin graft from the distal palmar crease and one from the midpalmar crease. RESULTS: Follow-up ranged from 3 months to 24 months. All glabrous skin grafts demonstrated complete taking the recipient sites and no incidence of the complete or partial loss. The donor site healed without complications, and there were no incidences of significant hypopigmantation, hyperpigmentation, or hypertrophic scarring. CONCLUSION: The important aspects of this method involve immediate return of glabrous skin to the defect site and restoration of the recipient site's crease by simple primary closure from adjacent skin. The glabrous skin of the palm provides the best tissue match for the reconstruction of the hands, but only a limited amount of tissue is available for this purpose. Full thickness skin grafting using palmar crease of the defects is the ideal way of reconstructing glabrous skin to restore both function and aesthetics and minimize donor site morbidity.

Surgical Treatment for Intranasal Synechiae

PURPOSE: Many authors reported about the post-traumatic nasal aesthetic complications. However, the studies for functional or intranasal complications are not enough yet. We identified relatively high prevalence of nasal obstruction and olfactory dysfunction in nasal synechiae, and the synechiae formation was a frequently occurred after the nasal bone reduction. And then, the aim of this study is to identify the usefulness of the treatment of intranasal synechiae. METHODS: We reviewed the data from 10 patients with symptomatic intranasal synechiae from June 2007 to June 2009. We enforced evaluation with preoperative CT in all patients but postoperative CT within complicated patients. We studied 10 patients with intranasal synechiae who had persistence postoperative symptoms. We studied the patients who were operated by removal of synechiae and ancillary surgical treatments in the last two years. RESULTS: In the previous report, the incidence of intranasal synechiae was 15%(n=62) and symptomatic synechiae was 16%(10/62). We classified the nasal bone fracture according to Stranc classification. In this paper, the incidence of treated intranasal synechiae was 13%(2/15) in Frontal Impact(FI) Type I, 11%(2/18) in FI Type II, 100%(2/2) in FI Type III, 0%(0/2) in Lateral Impact(LI) Type I, 25%(3/12) in LI Type II, and 33%(1/3) in LI Type III, respectively. After removal of synechiae, all patients improved nasal obstruction and little improved olfactory disturbance. CONCLUSION: Simple removal of synechiae by scissors improved postoperative symptoms and complications such as nasal obstruction and olfactory dysfunction. After removal of synechiae, all patients improved nasal obstruction, however, little improved anosmia. So, we thought that olfactory dysfunction may result in many intranasal factors. First of all, education of delicate procedure regarding this subject should be empathized accordingly.