[Gluteal flap harvest for breast reconstruction].

The lower gluteal flap is an autologous microsurgical breast reconstruction procedure using the soft tissue of the region of the gluteal sulcus. The perineal extension increases the volume of the sample. The pedicle with one artery and two large veins extends up the ischial notch and can reach 8 to 12cm.

Extensive levamisole-induced vasculitis.

Levamisole (an increasingly frequent contaminant of cocaine) can cause antineutrophil cytoplasmic antibody-associated vasculitis. Dermatologists should consider a diagnosis of cocaine/levamisole-associated cutaneous vasculopathy syndrome in cases of purpura of the ears and/or extensive retiform purpura in drug users. We report a case of particularly severe levamisole-induced necrotic purpura and immunological abnormalities in a 40-year-old woman.

Leg amputation and dystrophic epidermolysis bullosa: A case report with 15 years of follow-up.

Objective: Dystrophic epidermolysis bullosa is a rare disease characterized by widespread blistering of the skin and mucous membranes, which may ultimately prompt limb amputation. In this context, the outcome of fitting a prosthesis to a chronically wounded stump is not well known. Our patient's experience (with 15 years of follow-up) should contribute to better knowledge of this topic.

[Massive panniculectomy and bilateral subtotal mastectomy in a case of calciphylaxis: A case report and up date].

Calciphylaxis or calcific arteriolopathy is a rare, life-threatening obstructive pathology of the small cutaneous and subcutaneous vessels. It mainly affects patients with chronic renal failure but it also has been described in patients with normal renal function. The principal risks factors apart from renal failure and phosphocalcic metabolism imbalance are: the female sex, obesity, peripheral vascular disease, diabetes and oral anti-coagulation.

[The inferior gluteal musculocutaneous flap: Short and long-term results for 69 patients].

The inferior gluteal musculocutaneous flap described by Shaw then Le-Quang offers the possibility of harvesting a large amount of tissue with a well-concealed scar in the inferior fold. Since 1996, we used this flap for breast reconstruction without implant. The purpose of this study was to assess short and for long-term results in our patients.

Clinicopathological study of 13 cases of squamous cell carcinoma complicating hidradenitis suppurativa.

Background: To the best of our knowledge, only 52 cases of squamous cell carcinoma (SCC) complicating hidradenitis suppurativa (HS) have been reported since 1958. We describe 13 new cases.

Methods: We propose a clinical and histological analysis of our cases.

The submental flap in facial reconstruction: advantages and limitations.

Purpose: Complex defects resulting from surgical excision of facial cancer sometimes require reconstruction using microvascular free tissue transfer. Tissue transfer from areas distant from the face can resolve many problems, but often provides a poor cosmetic match with facial skin. The submental flap helps surmount this problem.

[Early surgical treatment of cutaneous hemangiomas].

Infantile hemangioma appears after the birth as a vascular tumor, which is known for its characteristic evolution in 3 phases: rapid augmentation then stabilization and involution on several years with in the best cases, classical "restitutio ad integrum". Usual surgical attitude is abstention and surgery is proposed only in order to treat sequel. But some particular situations require early surgery for life-threatening lesions or in case of functional impairment.

[Interstitial brachytherapy in management of primary cutaneous melanoma: 4 cases].

Background: Traditionally melanoma has been considered as a radioresistant tumor. However, recent observations regarding radiobiology and clinical response of melanoma have prompted physicians to re-evaluate the role of radiotherapy in the management of melanoma. Indeed, radiotherapy is frequently used in the treatment of metastatic melanoma but the role of this therapeutic approach in the primary tumor management is unclear.

[The lateral brachial flap: retrospective study of its face's utilisation between 1995 and 2002].

The lateral brachial flap is a fascio-cutaneus flap. This flap is secured. The functional and cosmetic sequelae are limited.

[To a margin reduction in the dermatofibrosarcoma protuberans? Retrospective study of 34 cases].

Introduction: The dermatofibrosarcoma protuberans (DFSP) is a rare but not exceptional tumour. Surgical treatment should contain a wide excision to avoid local recurrence.

Material And Method: We report a retrospective study of 34 cases treated by the same team from 1994 to 1999.

[Primitive cutaneous neuroendocrine carcinomas or Merkel's tumor. Clinical and therapeutic aspects in 22 patients].

Introduction: Primitive cutaneous neuroendocrine carcinoma (PCNC) is a rare tumor with poor prognosis. Surgery is the treatment of choice, but radiotherapy is taking a larger place in the management of these patients.

Methods: The files of 22 patients were studied retrospectively over a period of 14 years.

[Sebaceous hamartoma of Jadasshon: trichoblastoma mimicking basal cell carcinoma?].

The sebaceous hamartoma of Jadassohn is a congenital skin malformation usually appeared at birth or in early childhood. Many authors support the notion that early complete surgical excision is necessary to prevent the development of malignant neoplasms (especially basal cell carcinoma) after puberty. On the contrary, others in recent large series suggest that it is an histological misdiagnosis: the basal cell-carcinoma is in fact a trichoblastoma, basaloïd neoplasm, but non-malignant one.

[Reconstruction after total circular pharyngolaryngectomy: comparison between gastric interposition and free jejunal flap].

Aim Of The Study: To elucidate hospital mortality, morbidity and actuarial survival rates of patients with carcinoma of the hypopharynx and cervical oesophagus and to identify the technique of choice for reconstruction after pharyngolaryngectomy.

Patients And Methods: We reviewed the records of 209 patients who underwent total pharyngolaryngectomy between May 1982 and January 2000. The majority of patients had advanced cancer: hypopharyngeal in 131 cases and cervical oesophageal in 78 cases.

[Orbital exenteration].

Exenteration of the orbit is a disfiguring and destructive procedure that is usually reserved for treatment of life-threatening orbital malignancy when a less radical operation such as local surgery, chemotherapy, or irradiation are deemed inadequate or have failed. Many methods have been published for managing the socket, but of primary importance is the need to remove all diseased tissue prior to considering any reconstructive efforts. Options include spontaneous granulation, skin grafting, or muscle flaps.

[Extended nasal reconstruction with forehead flap. Report of a series of 12 adults].

The authors report a study about 12 cases of partial, total and extensive rhinectomy treated by a median "gingko flower" forehead flap. Technical adaptations are described to resolve the difficult problem of support and lining reconstruction. The authors compare their technique with the various other methods: the classical one (Converse scalping and sea-gull Millard's flaps) or more recent surgical solutions (distal composite flaps and expansion).

[Facial burns in children. 197 patients].

Facial burns frequently occur in child. A total of 197 burned patients with facial localisation were seen during the time period (1991-1996) covered by this retrospective study. One hundred and sixteen patients were less than three years old.

[Breast reconstruction using gluteal inferior free flaps. 34 cases in 30 patients].

Recent evolution of breast reconstruction favorised autologous tissues, without prosthesis. 34 gluteal inferior free flaps have been performed in 30 patients aged from 33 to 72 years for immediate reconstruction (6) or secondary reconstruction (28), unilateral (26) or bilateral (8 flaps); after complete mastectomy (21 included a bilateral one), partial mastectomy (3), sub-cutaneous mastectomy with skin-sparing mastectomy (3 bilateral cases), radical mastectomy with radiolesion (2), non efficient reconstruction using prosthesis (2). The myocutaneous flap vascularized by gluteal inferior artery was anastomosed on thoracodorsal pedicle or on humeral vein.

Composite reconstruction of hypopharynx and esophagus.

Extended surgical resection of the whole esophagus and associated hypopharynx may require composite reconstructions using a combination of pediculated and free tissue units. Twelve patients were assigned to composite reconstructions of the hypopharynx and esophagus for either metachronous carcinoma of the esophagus and head and neck (group I, n = 4), cervical anastomotic recurrence of esophageal carcinoma (group II, n = 3), or secondary reconstruction after the failure of a previous reconstruction of hypopharynx or esophagus (group III, n = 5). Pediculated tissues were the stomach (n = 10), colon (n = 1), or jejunum (n = 1).

[Giant multifocal venous malformation with monomelic predominance].

Introduction: Venous malformations are usually easy to recognise. We describe one case in which the clinical aspect was suggestive of Maffucci's syndrome.

Observation: A 44-year-old male, had numerous angiomatous nodules which could be emptied by pressure since infancy.

Survival after malignant tumors of the orbit and periorbit treated by exenteration.

Purpose: In order to further assess the survival value of orbital exenteration in malignant orbital and periorbital tumors.

Methods: The charts of 44 patients exenterated for a neoplasm of the orbit or periorbit were reviewed in a retrospective study.

Results: The overall 4-year survival was 45%.