Eccrine porocarcinoma: an extremely rare cutaneous tumor from a radiological point of view - case report and review of the literature.

Eccrine porocarcinoma is a rare type of skin neoplasm. It represents less than 0.01% of all epithelial cutaneous tumors. Early diagnosis is the only way to minimize the mortality rate, given its aggressive nature and the high rate of local recurrence and metastasis. Clinical diagnosis is challenging and the confirmation is histological. Few studies have been published about the radiological features of eccrine porocarcinoma. We report a case of a localized eccrine porocarcinoma along with ultrasound, MRI features, and a review of the literature to highlight the role of imaging in the diagnosis and treatment plan.

A thin superficial temporalis artery revealed by total necrosis of an island scalp flap, a case report.

INTRODUCTION AND IMPORTANCE: The superficial temporalis artery (STA) counts as one of the most reliable blood supplies capable of supporting the vascularization of the entire scalp. Therefore, total necrosis of a scalp flap based on the superficial temporalis artery is a rare complication. CASE PRESENTATION: A 43-year-old woman with a history of hypertension and cerebral stroke presented to our consultation for fronto-parietal scalp alopecia. The scar was the result of spontaneous healing of a chemical burn that occurred eight months earlier. We performed the first step of scalp expansion and raised a parietal expanded goblet island flap based on the right STA. In the postoperative period, the flap developed progressive necrosis. Despite the release of tension and stab incisions, the flap failed in a week. An angio-MRI revealed a thin STA on the right compared to the left side. After debridement, the necrosis was superficial, deep galea, and some subcutaneous tissues were viable. We performed a split-thickness skin graft that achieved a total wound closure. CLINICAL DISCUSSION: An extensive exploration of the vascular supply of the scalp before raising a scalp flap is not a common rule. The anatomical variation that we discovered as a thin superficial temporal artery may have explained the total failure of this flap surgery. CONCLUSION: Surgeons should keep in mind the possible existence of a detrimental anatomical variation when planning a single pedicled scalp flap.

Use of domestic tools to downstage the reconstructive ladder in a patient with severe crush and degloving injury: a case report.

In the COVID-19's crisis, elective surgery and non-emergent cases were postponed; all other procedures have to be minimized. A 17-year male patient with severe crush and degloving injury over the thigh, gluteal, sacral, and perineum areas was admitted to our Department on the 16th of March 2020. The patient presented soft tissue skin and muscle loss. A double Latissimus Dorsi and Anterolateral Thigh free flaps were indicated. However, due to the particular circumstance of the COVID-19 crisis, we applied domestic negative wound therapy (NPWT) using gauzes and wall suction. We obtained suitable granulation tissue after 17 consecutive days with this treatment. The raw area was then covered with an expanded split-thickness skin graft. The wound healed at 95%, and the patient was discharged on 25th of April 2020. He was followed up in an outpatient setting with wound care and physiotherapy. This case showed that in a limited-resource setting, with available wall suction, the domestic NPWT is a versatile tool to promote granulation tissue.

Unusual Evolution of Plexiform Neurofibroma in the Scalp: A Case Report.

The neurofibromatosis is a frequent and polymorphic genetic disorder. The severity is related to the complications. The degeneration of neurofibroma is a very rare complication of neurofibromatosis. In the literature, a few cases of solitary neurofibroma, which turned into a malignant tumor were reported. In our case, we described a very rare clinical case of neurofibrosarcoma in the scalp, and surgical treatment.