Prospective Study of Flap Surgery-Related Complications in Cutaneous Tumors: A Tertiary Care Institutional Experience of 6 Years.

Introduction: Flap surgeries are the standard choice for reconstruction of defects post excision of cutaneous tumours. Complications following these surgeries predominantly result as a consequence of bleeding, tension, ischemia, infection. Study Design: A Prospective study of patients treated for tumor excision and flap reconstruction between the period of 2014 and 2020 were followed up and complications encountered were analysed. Results: A total of 70 patients with cutaneous malignancies underwent flap surgeries. Complications encountered were bleeding, hematoma, infection, necrosis, pincushioning, keloid, hypertrophic scars. Conclusion: Successful outcome depends on pre operative evaluation, appropriate technique selection based on site of tumor, intraoperative care, post operative care and timely management of complications if any.

Evaluation of Clinical, Hormonal and Ultrasound Parameters of Male Reproductive System in Leprosy: A Cross-Sectional Study.

Background and Objectives: Testicular involvement in leprosy is neglected as it is insidious and silent, although it can have an impact on quality of life. Our study aimed at evaluating and estimating the frequency of the hormonal, radiological and clinical parameters in these patients. Materials and Methods: A cross-sectional study was conducted including 31 male leprosy patients attending our OPD. After detailed clinical assessment, patients were subjected to ultrasonological with Doppler examination of the scrotum and hormonal evaluation by ELISA technique for serum follicle-stimulating hormone (FSH), luteinising hormone (LH) and total testosterone. Results: Thirty-one patients were included with ages ranging from 19 to 54 with a mean of 34 years. Decreased libido (19.3%) was significantly observed in the abnormal FSH (P < 0.01) and testosterone (P < 0.01) groups. The majority of the clinical findings such as erectile dysfunction, infertility and altered pubic hair pattern were seen in the lepromatous spectrum. Six (19.6%) patients had increased LH and FSH. Twenty-three (74%) had testicular atrophy (<12 ml) as assessed by USG. There was a significant association between the bilateral decreased testicular volumes (TVs) and FSH (P = 0.016 on the left and P < 0.01 on the right). Four of 31 patients had altered testicular echo texture of which two belong to the BL spectrum. The increase in the resistive index (RI) corresponded significantly to the decreased TV (P < 0.01) albeit on the left side only. Conclusion: A sizeable proportion (74%) of the study sample had testicular atrophy. The significant association between increased RI and testicular atrophy, especially in patients with infertility, emphasises the ancillary role of Doppler indices in methodical diagnosis. Risk factors noted in the study include increased bacillary index, delayed initiation of treatment and recurrent ENL. Early detection, early initiation of MDT and specific therapies such as testosterone replacement can help improve the quality of life.

Nodular syphilitic scleritis: a rare and forgotten entity.

Ocular manifestations of syphilis are usually seen in the secondary or tertiary stages of the disease, which is a nonspecific inflammatory response. We report a case of unilateral nodular scleritis in a patient with late latent syphilis, which resolved with intravenous crystalline penicillin for 2 weeks, topical fluorometholone, and tobramycin eye drops for 3 weeks.

Evaluating the efficacy of primary excision and closure for the management of lip leukoderma and introducing the surgical site morbidity score as an effective tool for assessment of postoperative morbidity.

The lips are considered of great importance for the perception of beauty and there is still a lacuna in the attempt to successfully re-pigment resistant areas of vitiligo especially the lips. No technique evolved so far ensures 100% pigmentation with a good cosmetic appearance. To study the efficacy and cosmetic outcome following primary excision and closure in the management of lip vitiligo and assessing postoperative morbidity using the created surgical site morbidity score (SSMS). Twenty-five patients with vitiligo involving the inner margin of lower lips were posted for primary excision and closure of the vitiliginous area. Patients were followed up at 7 days and every 6 months. A SSMS including pain (P), healing time (H), and presence of complications (C) as parameters for assessment of postoperative morbidity were recorded at every follow-up visit. All patients showed healthy lip mucosa within 7 days of the procedure and no recurrence was noted at 24 months of follow up. The postoperative morbidity based on the SSMS was minimal, with a mean score of P2H8C0. Primary excision and closure technique is a safe and inexpensive modality in the management of lip vitiligo with immediate results and excellent cosmetic outcomes.

Post-steroid panniculitis: A rare case report.

Post-steroid panniculitis (PSP) is a rare clinical entity which presents after rapid withdrawal of high doses of systemic corticosteroids. As few as 20 cases have been reported in literature till now. Here, we report a case of post-steroid panniculitis occurring in a 9-year-old boy after rapid tapering and discontinuation of corticosteroids administered for the treatment of nephrotic syndrome. He presented with multiple erythematous painful indurated nodules over the face, arms, forearms, thighs, and legs. Histopathologic examination of the nodule revealed lobular panniculitis with lymphocytes, neutrophils, and multiple multinucleated giant cells. It also showed multiple needle-shaped clefts. Based on history, clinical features, and histopathologic findings, a diagnosis of post-steroid panniculitis was made and the patient was restarted on systemic corticosteroids. The lesions resolved in 4 weeks. We report this case to highlight the importance of gradual tapering of corticosteroids.