Herpes zoster in the ulnar nerve distribution.

Varicella zoster is a ubiquitous virus which usually affects school-aged children as Chicken Pox. While the initial disease is self-limiting and seldom severe, the virus remains in the body. It lies dormant in the dorsal root ganglia and reactivation may occur years later with variable presentations as Herpes Zoster, or Shingles. While Shingles is common, it rarely presents exclusively in the upper extremity. It is important that hand surgeons recognize the possibility of zoster infection, with or without a rash, when evaluating the onset of neuralgia in a dermatomal distribution in the upper limb. Early diagnosis allows rapid and appropriate treatment, with a lower risk of complications. We report on a case of Herpes Zoster isolated to the ulnar nerve distribution in a young woman.

Deepithelialization of a complex ventral hernia for completely extraperitoneal Rives-Stoppa herniorrhaphy.

Peritoneal incisions made during abdominal surgery are associated with numerous postoperative complications. Laparoscopic procedures are extraperitoneal, but they do not always provide adequate exposure of the defect nor room for manipulation. We suggest a de-epithelialization approach prior to mesh placement for the repair of large ventral hernias as a means of achieving a completely extraperitoneal ventral herniorrhaphy.