Management of large surgical defects of the forehead and scalp by imbrication of deep tissues.

Background: When facing surgical defects, the dermatologic surgeon follows certain basic principles that help reduce the inherent tension to allow for a better cosmetic outcome. These commonly include the use of undermining, releasing technique such as galeotomy if applicable, selection of suture material of appropriate tensile strength, and closure along relaxed skin tension lines.

Objective: To review the imbrication of deep tissues, another surgical principle aimed at wound tension reduction and widely utilized by cosmetic surgeons in forehead lifts and scalp reductions, as it applies to dermatologic surgeons in the repair of large surgical defects of the upper face and scalp.

Reduction of conchal enlargement and/or anterolateral rotation: otoplasty by the cosmetic dermatologic surgeon.

Background: Otoplasty is the correction of protuberant ears. One of the most common malformations responsible for prominauris is conchal enlargement and/or anterolateral rotation. The surgical technique we utilize for the correction of this type of auricular malformation is not unlike the removal of auricular skin and cartilage frequently performed by dermatologic surgeons in the treatment of cutaneous malignancies of the ear.

Auricular reconstruction of helical rim defects: wedge resection revisited.

Auricular reconstruction of an acquired helical rim defect is a clinical situation commonly encountered by dermatologic surgeons. Wedge resection is a simple but effective method for repairing such helical rim defects. This is a review of the wedge resection, outlining its indications, limitations, surgical technique, postoperative care, and pitfalls.

Cutaneous natural killer/T-cell lymphoma.

Lymphomas are classified as either Hodgkin's or non-Hodgkin's. The 2 subtypes of non-Hodgkin's lymphoma that can present primarily in the skin are cutaneous T-cell lymphoma and cutaneous B-cell lymphoma, both of which tend to be low-grade malignant neoplasms. Recently another distinct subtype of lymphoma was discovered, the natural killer (NK)/T-cell lymphoma, which can involve the skin in a primary or secondary fashion.