A Case of Lightning Burn with Flame Burn / 대한피부과학회지

Lightning injury is uncommon, as evidenced by the fact that most physicians never see or treat such a victim. To our knowledge, there were no reports of lightning burn with flame burn. We report a case of lightning burn with flame burn. On a rainy day, a 64-year-old woman with an umbrella in her left hand was walking along a road. When lightning struck the tip of her umbrella, her clothes were flamed. She threw herself into the water in a nearby field. The fire was extinguished. Then she lost consciousness, but she regained consciousness immediately. She was transported to our hospital. On arrival at our emergency center, her physical examination was remarkable. The patient had an entrance wound of the left palm and an exit wound of the left foot as well as 25 % total body surface burns, which were present in the flexor surface of the left hand, left arm, left leg and left flank. Histopathology showed epidermal and dermal necrosis. Three months later the burns were healed spontaneously, with some remaining scars.

Suction Auto Epidermal Graft on Removal of Epidermis of Depigmented Lesion with Radio-frequency Irradiation / 대한피부과학회지

BACKGROUND: Suction auto epidermal graft for the treatment of stable vitiligo has become popular clinically. In general, depigmented epidermis is removed by liquid nitrogen freezing for preparation of the recipient site. There have been some problems with the nitrogen freezing method, uneven repigmentation, appearance of Koebner's phenomenon on normal colored skin around the graft site, scar formation on recipients sites. In our view these resulted in unwanted damage to the dermis and epidermal and skin appendageal melanocytes of normal skin by freezing. OBJECTIVE: To introduce a method to remove the depigmented epidermis of recipient site with minimal unwanted damage to melanocytes and dermal tissue. METHODS: Using Ellman surgitron, irradiation equipment of 3.8MHz frequency the depigmented epidermis was removed with a blade electrode under rated electric power around 10 watts depending on the thickness of the epidermis. Operating mode was fully filtered current for minimal charring and destruction of tissue through pure micro-smooth cutting. RESULTS: In the case of removal of the epidermis with Ellman surgitron, oozing and inflammation decreased markedly compared with those applied with liquid nitrogen. And it was confirmed histopathologically that there was no significant unwanted destruction of healthy tissue. Moreover, the electrode of Ellman surgitron is designed to be apt to trace the margin of depigmented lesion. And Ellman surgitron features a continuously linear intensity setting for precise, predictable control to minimize tissue destruction and charring. So we were able to remove the epidermis of the shallow lesion looking like a pseudopod and of the thinnest part of the body like eyelid also. And we grafted normal epidermis successfully on the depigmented lesion. CONCLUSION: The removal of depigmented epidermis by radio-frequency gave satisfactory results in the suction auto epidermal graft by overcoming the defects shown as depigmented epidermis which were removed by liquid nitrogen freezing. And this method made patients comfortable because of less pain, a one day operation procedure and good results.