ABSTRACT
AIM: The repair of an eyelid-wide full-thickness defect is a challenging procedure, mostly for the tarso-conjunctival layer reconstruction. The Authors illustrate their own experience in reconstructing eyelid-wide defects with a composite venous wall and skin graft to repair both neoplastic and post-traumatic injuries, aiming to reach both functionally and cosmetically satisfactory results. PATIENTS AND METHODS: Eight patients were treated with this procedure; six of them were affected by a local invasive tumor, two had a wide defect following a trauma. RESULTS: Most of the patients had good functional and cosmetic results after a median follow-up of 51 months; only one had a minor complication. CONCLUSION: Eyelid reconstruction with a venous wall and skin graft is a recently introduced technique that represents a reliable alternative to traditional procedures, granting esthetically and functionally good results.
Subject(s)
Eyelid Neoplasms/surgery , Eyelids/abnormalities , Plastic Surgery Procedures/methods , Saphenous Vein/transplantation , Adult , Aged , Aged, 80 and over , Conjunctiva/pathology , Eyelids/surgery , Female , Humans , Male , Skin Transplantation , Transplantation, AutologousABSTRACT
Malignant syphilis is now considered a rare disease, more commonly affecting individuals with poor health, malnutrition or HIV infection. We present a 34-year-old man with HIV infection who developed multiple atypical cutaneous ulcerations, leonine facies, a scleral nodule and keratitis with visual loss. The diagnosis of malignant syphilis was delayed due to the insidious presentation, but was confirmed via immunohistochemical (IHC) staining with anti-Treponema antibodies of a skin biopsy. Significant clinical improvement was observed following a 15-day course of penicillin and tigecycline therapy. In advanced HIV disease, cutaneous manifestations are often difficult to identify and present a challenge for the clinician. Clinical manifestations of secondary syphilis vary greatly, earning the epigram of 'the great imitator'. It is important to recognize atypical presentations of syphilis, especially among HIV-infected individuals. Unlike historical cases of malignant syphilis, Treponema pallidum was found in the tissue section using IHC staining methods. We emphasize the importance of lues maligna in the differential diagnosis of HIV-infected patients with diffuse ulceronodular lesions as well as the usefulness of histological investigations and IHC studies.
Subject(s)
Eye Diseases/diagnosis , HIV Infections/complications , Syphilis/diagnosis , Adult , Anti-Bacterial Agents/administration & dosage , Biopsy , Eye Diseases/drug therapy , Eye Diseases/microbiology , Eye Diseases/pathology , Humans , Immunohistochemistry , Male , Minocycline/administration & dosage , Minocycline/analogs & derivatives , Penicillins/administration & dosage , Syphilis/drug therapy , Syphilis/microbiology , Syphilis/pathology , Tigecycline , Treatment Outcome , Treponema pallidum/isolation & purificationSubject(s)
Anemia/etiology , Melanoma/complications , Skin Neoplasms/complications , Syncope/etiology , Anemia/pathology , Dermatologic Surgical Procedures , Disease Progression , Erythrocyte Transfusion , Female , Humans , Melanoma/diagnosis , Melanoma/pathology , Melanoma/surgery , Middle Aged , Skin/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/surgeryABSTRACT
The activity of phospholipase A2 was tested both in rat skin and human psoriatic skin before and after systemic treatment with a retinoic acid derivative: RO 10-9359. An increase of activity was found in the rat skin homogenates when the animals were treated with 3 mg/kg/day of the drug for 8 days, while no effect was found following treatment with 1.5 mg/kg/day for 10 days. On the contrary a decrease of this activity was found in homogenates from both involved and uninvolved skin of psoriatic patients after systemic treatment with 1-1.5 mg/kg/day for 10 days. These different results are discussed also in the light of the clinical effect of RO 10-9359 on psoriasis.
Subject(s)
Etretinate/pharmacology , Phospholipases A/metabolism , Phospholipases/metabolism , Psoriasis/enzymology , Skin/enzymology , Tretinoin/analogs & derivatives , Adult , Aged , Animals , Arachidonic Acid , Arachidonic Acids/metabolism , Humans , In Vitro Techniques , Lipid Metabolism , Male , Middle Aged , Mitochondria, Liver/enzymology , Phospholipases A2 , Rats , Rats, Inbred StrainsSubject(s)
Phospholipids/metabolism , Psoriasis/metabolism , Skin/metabolism , Adolescent , Adult , Aged , Arachidonic Acids/metabolism , Etretinate/therapeutic use , Female , Humans , Male , Middle Aged , Phosphatidylcholines/metabolism , Phosphatidylethanolamines/metabolism , Phosphatidylinositols/metabolism , Psoriasis/drug therapySubject(s)
Heart Failure/diagnosis , Aged , Cardiac Output , Humans , Lung Diseases, Obstructive/diagnosis , Male , Middle AgedSubject(s)
Heart Failure/complications , Pulmonary Edema/etiology , Uremia/complications , Adult , Aged , Dehydration , Humans , Male , Middle Aged , Mitral Valve Stenosis/complicationsABSTRACT
A comparison was made between the bronchodilatatory activity of phenoterol (hydroxyphenylorciprenaline) and salbutamol in patients with bronchial asthma. The results showed that both drugs had marked activity at therapeutic doses, though phenoterol was more rapid (within 10 min of inhalation) and more longlasting (up to 6-7 hr). Its loss of therapeutic effect was also slower than that of hitherto experimented drugs.
