A Case of Breast Reconstruction Using Pedicled TRAM Flap in Psoriasis Patient

ABSTRACT

Psoriasis is a common and unpredictable chronic immune mediated disease charcterised by skin lesions and associated with arthritis. Complete remission is very rare. Prevention of acute exacerbation is mainstay of the treatment. At present, risk of surgery in psoriasis patient is uncertain although some dermatologic literatures reported that well controlled psoriasis is usually not cause surgical complications. We experienced a case of wide necrosis of flap in chronic psoriasis patient after immediate breast reconstruction with pedicled transverse rectus abdominis flap. Psoriasis is well known to have chronic skin damage from characteristic histopathologic findings of Munro's micro abscess, dermal arteriolar tortursity and hyperplasia. Such pathologic feature may induce congestion of flap and wide necrosis of flap.