Melanoma of the scalp: the invisible killer.

A series of 20 patients (15 men and 5 women) suffering from malignant melanoma of the scalp is reported. Their epidemiologic data and outcome are described. The ages ranged from 48 to 78 years (mean 63 years). Analysis of the cases demonstrated that lesions occurring posterior to the tragal line (in hair-bearing area) have the worst prognosis. The 5-year survival rate was poor; 12 patients died within this period. Two representative cases are described, and the preventable aspects of the disease are emphasized.

Costal osteomyelitis due to an electrical burn.

This article describes the case of a patient who suffered an electrical full thickness burn of the chest wall and a concomitant osteomyelitic complication of two ribs. A review of the existing literature on bone and joint changes after burns is presented. Osteomyelitis of ribs must be kept in mind while treating patients for chest wall burns.

Rare sites of melanoma: melanoma of the external ear.

A small series of melanomas of the external ear is presented. The presentation in general was late and they varied from 2.6 mm to 4.8 mm in thickness. The outcome in most of the patients (9 patients) was bad and within 3 years only 4 survived. The fact that 9 patients remembered having a nevus that suddenly changed to melanoma emphasizes the need for early removal of such nevi.

Lipomatosis of the scalp and macrocephaly.

In summary, a case of macrocephaly and lipomatosis of the scalp and forehead has been presented. The phenotypic and clinical features found in our patient are in accordance with previous reports. The differential diagnosis with other hamartoneoplastic syndromes has been evaluated and discarded, concluding that the present report is in accordance with Bannayan-Zonana syndrome. However, as in other inherited traits, finding a genetic test to diagnose this entity remains a challenge.

Terrorist bombing with a 'Molotov cocktail' inside travelling cars: an old weapon for a new burn syndrome?

The 'Molotov cocktail' terrorist weapon which is thrown into a travelling car has given a new type of injury to people who sustain massive smoke inhalation together with disfiguring burns of face, thighs, hands and chest, and post-traumatic psychological disorder. The combination of petrol ignition with the synthetic fumes inside the care is a unique occurrence with a high morbidity and mortality which is difficult to treat and to manage. We propose to show that the combination of all the above components can be defined as the 'Molotov cocktail' burn syndrome.

Cyclosporin A treatment failed to extend skin allograft survival in two burn patients.

Prolongation of skin allograft survival by immunosuppression of burn casualties has been reported sporadically during the past two decades. Recently cyclosporin A (CycA) has been used effectively for such an indication. We report here two paediatric patients with extensive burns (85-95 per cent BSA) treated with fresh, family-related skin allografts that were rejected during CycA treatment after 14-18 days. One of these children survived while the other died with candida sepsis.

The inframammary midline triangle in reduction mammaplasty: the renewal of an old idea.

The junction between the inframammary and vertical suture lines after reduction mammaplasty is a weak point well known to plastic surgeons. This junction is prone to either necrosis or disruption, or both, in some cases. A small triangle of skin left in that location may prevent this problem. This is done routinely in all the cases of McKissock reduction mammaplasty, but it could be employed in any other techniques as well. The cosmetic appearance is good. The method, which is not new and has been used in the past, has been found very helpful and is described here along with its advantages.

Hand metastasis from renal cell carcinoma with no bone involvement.

Hand metastases account for 0.1% of all metastases and most of them involve primarily the bones. A case of a metastasis from renal cell carcinoma to the distal segment of the little finger with no bone involvement is described. In view of the fact that the kidneys are the origin of only 10% of hand metastases, such a case is extremely rare.

Very deep burns of the hand due to low voltage electrical laboratory equipment: a potential hazard for scientists.

A low voltage (24 V) electrical deep burn of the hand injured a professor of applied physics when performing an experiment in his laboratory. The potential hazard of the equipment is described, the injuries are reported and the literature is reviewed.

The use of sandpaper in chemical peeling combined with dermabrasion of the face.

The combined use of chemical peel and dermabrasion of the face was widely accepted since the first reports of DuPont and Horton. We present a refinement of this combined method by introducing the use of a simple diathermy head cleaner (Surgikos, Inc) as a safer method of face abrasion. This disposable device, available at every surgical theater allows a better control of the abrasive tool, permits a more accurate depth of the abrasion, and reduces the incidence of unexpected complications in this combined technique.

Chemical burn due to contact with soda lime on the playground: a potential hazard for football players.

Two football players were treated for chemical burns of their genitalia and medial thighs caused by contact with soda lime used to line a playground. The cases are reported and the unusual mechanism causing the injury is described.

A rare case of arhinia with severe airway obstruction: case report and review of the literature.

A rare case of a newborn suffering from arhinia with complete airway obstruction is reported. The complexity of the life-threatening airway obstruction is described and adequate treatment is reported. The relevant literature is reviewed, and the different approaches to treatment are discussed.

Nasal tampon packing in rhinoplasty: a simple and safe method of hemostasis.

To absorb bleeding and pack the nasal cavities after rhinoplasty, a sterile commercial vaginal tampon was used. It has the following advantages: high absorbency, round configuration, and safety removal cord included to preclude gliding into the nasopharynx.