Reliability of lymphatic mapping after wide local excision of cutaneous melanoma.

Background: Since the advent of sentinel lymph node (SLN) biopsy, patients with cutaneous melanoma have been referred to surgeons for consideration for SLN biopsy, sometimes even after the wide local excision (WLE) of the primary melanoma has been performed. This has raised the question of the reliability and validity of a lymphoscintigram performed for lymphatic mapping of the SLN after there has been anatomic rearrangement of the skin following the WLE of this primary melanoma.

Methods: We conducted a prospective study of 20 consecutive patients with cutaneous melanomas with thickness less than 1.

Anatomy of the Caucasian alar groove.

Anatomic studies performed on the noses of 15 cadavers examined the alar groove, alar lobule, and lower lateral crus areas both microscopically and on gross appearance to determine what effect these structures have on overall nasal appearance. In contrast to the findings of previous studies, the authors found the alar lobule to be an area in which dermis is interdigitated with muscle throughout and up to the alar rim. The anteroposterior lengths of the lower lateral crura were again seen to vary in length, presence or absence of accessory cartilages, and shape.

The soft triangle revisited.

Five cadaveric adult human noses were examined to further elucidate the region of the soft triangle of the nose. Three distinct zones were found. Zone 1, just caudad to the lower lateral cartilages, consists of the fibers of the dilator nares anterior as it inserts into the dermis.