Basal cell carcinoma with signet ring cell morphology accumulating the ubiquitinated cytokeratin 5/6.

Basal cell carcinoma (BCC) showing signet ring (SR) cell morphology is a very rare variant of BCC. Here, we report BCC with SR cell morphology developed in the right cheek skin of a 79-year-old man. Histopathologic examination showed irregularly shaped islands of basaloid cells with characteristic peripheral palisading.

The Modified 3-square Flap Method for Reconstruction of Toe Syndactyly.

Bandoh reported the 3-square-flap method as a procedure for interdigital space reconstruction in patients with minor syndactyly. We recently modified this flap design so that it could be used in the treatment of toe syndactyly involving fusion of the areas distal to the proximal interphalangeal joint. With our method, the reconstructed interdigital space consists of 4 oblong flaps (A through D).

Usefulness of Titanized Polypropylene Mesh and an Anchor System for Correction of Lower Lid Retraction.

Because of the lower eyelid's free edge anatomy, it is difficult to preserve its contours after reconstruction. We recently attempted a new operative procedure to treat 2 cases of lower lid retraction by using a titanized polypropylene mesh and an anchor system. As the lower lid skin is elevated laterally in an oblique upward direction, the location of the mesh insertion is decided and the site is marked accordingly.

Usefulness of Simple-Designed Bilobed Flap for Reconstruction of Ischial Decubitus Ulcer.

The pressure ulcer of the ischial region is often accompanied by complete paraplegia in patients with spinal cord injury and is attributable to the compression and breakdown of tissue arising from constant sitting. Characteristically, a pressure ulcer of this region is circular and deep. We recently reconstructed ischial decubitus ulcer of 8 patients using simple-designed bilobed flap.

Usefulness of S-shaped Incision in Large Nevus Sequential Excision.

We devised the S-shaped incision as a technique for large nevus sequential excision. Using this technique reduces the number of operations needed to complete nevus resection and also shortens the final length and width of the scar. We report this technique after performing it on 7 patients and confirming its usefulness.

Usefulness of Ω-shaped Incision in Skin Tumor Excision.

We devised the Ω-shaped incision as a technique for skin tumor resection on the areas of skin with an arc-shaped fold. With this technique, the dog-ear that is formed during 6 wound closure can be resected within the range of the first skin incision. We report this technique after performing it on the face or trunk of 18 patients and confirmed its usefulness.

A new surgical procedure for little toe polysyndactyly without skin graft.

We developed a new operative procedure involving the combination of 5 flaps to treat little toe polysyndactyly. We applied this procedure to 4 toes of 3 patients who had severe polysyndactyly involving skin fusion of the area from the distal interphalangeal joint to the periphery. In all 3 patients, this procedure allowed easy transfer of the flaps, caused no tension to the wound during skin suturing, and did not disrupt blood flow through the flap.

Rhomboid flap with multiple Z-plasty for treatment of hypertrophic scar on the pubic area.

The pubic area is prone to the development of hypertrophic scars; however, few studies have reported on the valid means of treating hypertrophic scars affecting this area. We have recently devised a new operative procedure, 'rhomboid flap with multiple Z-plasty', for the treatment of this condition. For this operative procedure, the defect after resection of the scarred tissue in the pubic area is first covered with a rhomboid flap elevated from the hypogastric area, followed by applying multiple Z-plasty to the suture wound of the donor site.

Treatment of severe deformities of the toenails by the modified Zadik method with artificial skin.

A number of operations have been devised to treat ingrowing toenails and pincer nails, and they have given good aesthetic and functional results. However, there have been few reports of operations for the treatment of severe nail deformities caused by damage to the matrix of the nail by injury, or by inappropriate removal of the nail or intractable onychomycosis or cardiovascular or neurological disorders. In 1950, Zadik reported a radical technique for ingrown nails and pincer nails: after avulsion of the nail, the matrix was excised completely and the posterior nail wall was sutured to the nail bed as an advancement flap.

Correction of auricular deformity caused by high ear-piercing: case report.

In recent years, high ear-piercing and wearing earrings in the cartilaginous region of the auricle have become popular. The frequent occurrence of subsequent complications also has been pointed out. The present case is of a 17-year-old girl with an auricular deformity caused by infections occurring after piercing in the scapha.

Exposed artificial bone in the forehead covered with a transverse orbicularis oculi myocutaneous flap.

We have reconstructed the forehead by covering exposed artificial bone with a transverse orbicularis oculi myocutaneous flap. This technique had the following advantages: good circulation in the flap extended the arc of rotation; the flap matched the forehead in colour and texture; the scar of the flap donor site was not conspicuous, and no dysfunction was seen; and the technique is simple and not invasive.