• Archives of Craniofacial Surgery
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• v.22 no.3
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• pp.173-176
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• 2021

Basal cell carcinoma is a malignant epithelial neoplasm of the skin and the most common human skin cancer. It is generally associated with a good prognosis. In this case report, a giant basal cell carcinoma of the nodulo-ulcerative type showing wide ulceration with marginal multiple small nodules, is presented. It was trapezoidal in shape, having dimensions of 7 cm at the greatest basal width, 6 cm vertically with different anterior and posterior margin dimensions, and 5 cm horizontally at the top margin. After wide excision of the lesion including 5-10 mm safety margins, the wound was reconstructed with a local skin flap and split-thickness skin graft. The reconstructed wound healed well without recurrence for 1 year.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.227-230
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• 2018

"Paraffinoma" is a well-recognized complication of paraffin oil injection into various body parts for an aesthetic purpose. After a variable latency phase, paraffinoma can present as a wide range of clinical symptoms. This paper is a case report of surgical excision of the paraffinoma and subsequent reconstruction of the associated skin defect on bilateral preauricular cheeks, manifesting 50 years after a primary injection.

• Archives of Plastic Surgery
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• v.35 no.3
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• pp.261-266
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• 2008

Purpose: The incidence of skin cancer is increasing throughout the world including Asian countries such as Korea. Still there are only limited reports of the clinical features of skin cancer in Korea, especially in the fields of plastic surgery. This study is to demonstrate the recent clinical trends of skin cancer and the treatment of skin cancer in Korea by analyzing a single institution's experience. Methods: During a 11-year period, 370 patients visited our department for the excision of skin cancer. Data of the patients such as histopathologic diagnosis, primary site of the tumor, age and sex of the patient, operative methods were reviewed retrospectively. Results: We had 370 patients, 215 men and 155 women. The ages ranged from 10 to 95 years with a mean of 58.8 years. A total of 143 patients were diagnosed as basal cell carcinoma, while 100 were malignant melanoma, 80 were squamous cell carcinoma, 17 were dermatofibrosarcoma protuberans, and 30 were other miscellaneous skin cancers. Local flaps were the most frequently used reconstructive method after wide excision of the cancer, which was followed by primary closure, split-thickness skin graft, free flap and full-thickness skin graft. Conclusion: There was a gradual increase in the incidence of skin cancer after the year 2000. Basal cell carcinoma had the highest incidence which frequently involved the sun-exposed regions in the old ages. Malignant melanoma showed a relatively high incidence compared with other previous studies in Korea. The extremities were the most frequent location for malignant melanoma. Clinical features of other various skin cancers were also reported in this study. The reconstructive method highly depends on the primary site of the cancer, while local flaps were the mostly used operative technique.

• Archives of Plastic Surgery
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• v.35 no.5
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• pp.539-544
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• 2008

Purpose: There have been limited reports on breast reconstruction after excision of phyllodes tumor. This paper reports four patients who had immediate reconstruction of the breast following excision of phyllodes tumor. Methods: We retrospectively reviewed the medical records of 14 patients from March 2000 to March 2008. Clinical data were analyzed including age, presenting symptoms and signs, type of surgery and metastasis. Results: The mean age was 38.6 years. The mean follow-up period was 40.6 months. Reconstruction was performed with latissimus dorsi musculocutaneous flap in 3 patients and transverse rectus abdominis musculocutaneous flap in 1 patient. Other cases were covered with skin graft or primary repair. 2 local recurrent cases were noted. Conclusion: The breast affected by phyllodes tumor must undergo complete excision. Followed by mastectomy, immediate reconstruction of breast improved cosmetic results, and allowed a wider surgical excision margin of tumor.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.663-666
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• 2012

Current treatments for hidradenitis suppurativa (HS) include prolonged courses of antibiotics, retinoids, immunosuppressants, and biologics. Severe cases that are resistant to prolonged medical treatment pose a therapeutic challenge. We propose radical excision and lateral thoracic flap reconstruction as a treatment option for such cases. In our experience with two patients, good aesthetic and functional outcomes were achieved, with a high level of patient satisfaction. The availability of suitable flap coverage allows for wide resection of all of the hair-bearing skin, leading to a low incidence of residual disease and subsequent recurrence. Following excision of the affected tissue, the ideal reconstructive method in the axilla provides suitable coverage without unacceptable donor site morbidity and also avoids axillary contractures. A long lateral thoracic flap with delay has excellent coverage with minimal donor tissue sacrifice. With a suitable flap coverage option, the management paradigm of intractable HS should shift from prolonged medical treatment to allow decisive radical excision, which will improve the quality of life for patients.

• Archives of Plastic Surgery
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• v.40 no.1
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• pp.57-61
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• 2013

Background Von Recklinghausen disease or neurofibromatosis type 1 is an autosomal dominant genetic disorder of chromosome 17q11.2. The most common characteristic findings of NF 1 include multiple and recurrent cutaneous neurofibromas associated with psychosocial distress. Methods Sixteen patients (9 female, 7 male; average age, 31 years; range, 16 to 67 years) with multiple cutaneous neurofibromas between March 2010 and February 2012 were included in the study. All patients were treated with radiosurgical ablation and excision under general anesthesia. Results All 16 patients were satisfied with the results, when questioned directly during the outpatient department follow-up. The only complaint from a few patients was minimal scarring, but acceptable results were obtained in the end. Conclusions The radiofrequency procedure is almost bloodless and quick, creating a smaller necrotizing zone. Therefore, instead of employing the time consuming traditional surgery, such as laser therapy and electrosurgical excision, that produces uncertain results and can affect normal adjacent tissue, treatment of neurofibromas with radiofrequency ablation and excision can be an alternative choice of treatment for patients with a large number of neurofibromas.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5709-5714
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• 2015

Aim: To assess the treatment outcome in patients with malignant skin melanoma and prognostic factors for distant metastases (DM), disease-free survival (DFS) and overall survival (OS). Materials and Methods: A retrospective analysis was conducted on 113 patients with malignant skin melanoma (60 females, 53 males, average age-55 years) who were treated surgically. Primary treatment consisted of local excision. In 12 cases, it was accompanied by lymph node excision. In 93 (82%) cases, radicalization was necessary, which was either local only (19 cases) or accompanied by lymph node surgery/biopsy (74 cases). Possible prognostic factors such as Clark's stage and Breslow's depth of invasion, ulceration, average tumor dimensions, lymph nodes metastases (pN+), gender, tumor location and primary excision margins were considered. Results: In 51 (45%) cases, treatment failure occurred. The 5-year DM rate was 47%, the 5-year DFS was 38%, and the 5-year OS was 56%. In the univariate analysis, the important factors with respect to at least one endpoint included Clark's stage, Breslow's depth of invasion, ulceration, average tumor dimensions, lymph nodes metastases, gender and primary tumor localization. The presence of metastasic nodes was the most important prognostic factor, with a 5-year DM rates of 30% for pN(-) and 76% for pN(+) and a 5-year DFS and OS of 56% and 76% for pN(-) and 13% and 24% for pN(+), respectively. The average tumor dimension was independently significant for DFS and OS, with 5-year rates of 69% and 80% for ${\leq}1cm$, 28% and 53% for 1-2 cm, and 18% and 30% for >2 cm, respectively. Tumor location was also significant for DM and OS, with 5-year rates of 69% vs 33% and 41% vs 66% for trunk vs other locations, respectively. Conclusions: The natural course of a malignant skin melanoma treated radically is disadvantageous, with unsuccessful outcome in nearly half of the cases. Common clinical factors, such as Clark's tumor stage, Breslow's depth of invasion and the presence of metastatic nodes, have high prognostic significance. The size and location of the primary lesion may be considered independent prognostic factors. The most important negative prognostic factor is the presence of metastatic regional lymph nodes. Only one quarter of patients with metastases in lymph nodes survive 5 years from primary surgery.

• Korean Journal of Head & Neck Oncology
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• v.4 no.1
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• pp.21-28
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• 1988

Skin replacement in large cheek defects after excision of benign or malignant tumor on the face is a challenging task. The physical characteristics of cheek skin are matched best by adjacent skin. Various methods of reconstructing of the facial surface such as forehead flap, distant flap, or a full thickness or split thickness skin graft have replaced adjacent tissue for coverage in many cases. We have reviewed ten cases of aesthetic reconstruction of the face after resection of the facial skin tumor within the last 5 years. The first group of 3 patients were reconstructed with split thickness skin graft from the scalp or lower abdomen. The second group of patients were reconstructed with cheek flap. The third group of 3 patients were reconstructed with cervicofacial flap. The last 2 patients were reconstructed with nasolabial flap & island falp respectively. The advantages from our experience with various method of coverage are its hidden donor area & good color match with the facial skin & increased success rate.

• Archives of Craniofacial Surgery
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• v.23 no.4
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• pp.187-189
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• 2022

Patients with pixie ear have an attached, tapering, and low-set earlobe. Traditional methods usually describe excision of the caudal portion of the lobule and reattachment in a more superior position. The present report suggests a simplified skin redraping method for correction of pixie ear. The procedure provides easy method to design and perform, which only requires elevation and trimming of the skin. Other ancillary procedures, such as flap design, anchoring, plication, and subdermal fixation, are not required. This method produces satisfactory results. Postoperative scar is invisible because the incision is on the retroauricular region, and the corrected earlobe has a more natural appearance than the repositioned earlobe. Moreover, skin redraping avoids tension, which contributes to minimization of the postoperative scar.

• Korean Journal of Audiology
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• v.23 no.4
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• pp.210-213
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• 2019

The auricle is a three-dimensional cartilaginous frame covered with thin overlying skin. Due to its complex features, reconstructing helical rim defects after the excision of an auricular mass is challenging. Shortage of subcutaneous tissue and the presence of a tightly bound epithelium further hamper the primary closure of lateral (anterior) auricular skin defects. We present herein a case in which we used a helical rim advancement flap along with an additional postauricular skin flap. We achieved a satisfactory esthetic result with minimal loss of helical diameter and a low risk of flap necrosis by preserving the vascular network of the flap. This technique is less traumatic and will facilitate faster healing as well as improved patient recovery.