Clinical Significance of the Modified Triple Advancement Flap for Closing Skin Defects / 대한피부과학회지

BACKGROUND: Triple advancement flap has been recently introduced to close the skin defect after Mohs microscopic surgery. OBJECTIVE: The aim of this study is to evaluate the clinical advantage of the modified triple advancement flap compared with rhomboid excision and closure. METHODS: The modified triple advancement flap was performed on nine patients with skin cancer. We observed the clinical course after surgery and compared the scar length and the amount of removed normal skin in triple advancement flap with those in rhomboid excision and primary closure, by using an image-analyzing program. RESULTS: The overall cosmetic and functional result was good. Partial flap necrosis was detected in one of nine patients, and hypertrophic scar developed in one of nine patients. The average scar length from the modified triple advancement flap was 102.1 mm, whereas it was 95.0 and 111.0 mm in 1:3 and 1:3.5 rhomboid excision with closure. The amount of removed skin was 716.3 mm2 in modified triple advancement flap, whereas it was 794.0 mm2 (1:3) and 1116.9 mm2 (1:3.5) in rhomboid excision with closure. CONCLUSION: The triple advancement flap might be used to close a defect in the area of trifurcation or bifurcation of skin tension lines, to spare the normal surrounding tissue as much as possible.

Dystrophic Calcinosis Cutis with Transepidermal Elimination Secondary to Localized Scleroderma / 대한피부과학회지

Localized scleroderma is a connective tissue disorder characterized by thickening and fibrosis of the skin due to excessive collagen deposition in the dermis. Dystrophic calcinosis occurs when calcium is deposited in the previously damaged skin tissue, and calcium and phosphorous levels in the blood are within normal limits. It occurs secondary to connective tissue disease, infection, inflammatory processes, chronic venous stasis, cutaneous neoplasm, and trauma. We report a rare case of dystrophic calcinosis cutis with transepidermal elimination secondary to localized scleroderma.

A Case of Generalized Granuloma Annulare That Clinically Presented as Erythema Annulare Centrifugum / 대한피부과학회지

Granuloma annulare (GA) is usually a benign, self-limiting, granulomatous, chronic dermatosis of an unknown cause, characterized by skin colored papules that often have an annular configuration. Generalized granuloma annulare (GGA) is an uncommon variant of GA, and this is characterized by disseminated papules on the trunk and limbs. We report here on an interesting case of GGA that clinically presented as erythema annulare centrifugum.

A Case of Acquired Zinc Deficiency in a Patient with Ischemic Colitis / 대한피부과학회지

Zinc deficiency is characterized by acrodermatitis enteropathica like eruption such as periorificial dermatitis, diarrhea and mental irritability. This syndrome occurs due to decreased supplementation, increased consumption or decreased bowel absorption of zinc. We report here on a case of acquired zinc deficiency in a patient who was receiving total parenteral nutrition due to ischemic colitis. She showed denuded patches on the perinasal, perioral and perineal area and tense bullae on both hands. She was suffering from diarrhea and mental irritability. Her blood zinc level was 4.9microng/dl. Subsequent intravenous zinc supplementation cleared up her clinical manifestations.

A Case of Becker Nevus Syndrome with a Tooth Defect andFibrous Dysplasia of the Sphenoid Bone / 대한피부과학회지

Becker nevus syndrome is a phenotype characterized by the presence of a Becker nevus in association with unilateral hypoplasia of the breast or other cutaneous, muscular or skeletal defects. We report an interesting case of Becker's nevus syndrome associated with fibrous dysplasia of the sphenoid bone, tooth abnormalities and facial asymmetry.

A Case of Milker's Nodule / 대한피부과학회지

Milker's nodule is a harmless skin lesion that's caused by the paravaccinia virus (also called pseudocowpox virus), which is a member of the genus Parapoxviridae. It occurs worldwide, but it is prevalent only in individuals who are in close contact with cattle. We report here on a woman who presented with a dusky purpuric center surrounded by a white or gray ring and an outer red halo on the back of the right hand. Histologically, intracytoplasmic inclusion bodies were evident in the upper epidermis, and these revealed cylindrical virus particles on electron microscopy. Parapoxvirus was identified by polymerase chain reaction with using pan-parapoxvirus primer 1 (PPP-1) and PPP-4.