Nevus lipomatosus superficialis is a fairly uncommon disease characterized by ectopic fat tissue in the dermis. Lesions most commonly occur on the lower trunk, especially on the back, buttocks or abdomen. Rarely, lesions also occur on the knee, axilla, arm, ear and scalp. To our knowledge this is the first case of nevus lipomatosus superficialis developing on the dorsal foot.
Abdomen ; Arm ; Axilla ; Buttocks ; Dermis ; Ear ; Foot* ; Knee ; Nevus* ; Scalp

PURPOSE: The deep inferior epigastric perforator (DIEP) free flap is well known as an ideal donor site for the breast reconstruction. The flap can provide huge amount of fat tissue for breast and buttock contour, while it is also very useful as a thin skin flap to reconstruct the upper and lower extremities. We used a DIEP free flap in various site reconstructions besides the breast and would like to reinsure the usefulness of this flap. METHODS: Twenty nine consecutive patients who underwent DIEP free flap surgery from 2001 January to 2007 December were reviewed. The case constituted seven male patients and twenty two female patients. There were sixteen breast reconstructions, five face reconstructions, five lower extremity reconstructions, two upper extremity reconstructions, and one buttock contour reconstruction. All clinical data were based on the patient's medical records. RESULTS: All DIEP free flaps survived without major complications. There was no hematoma, seroma, or partial necrosis. The donor sites were closed primarily with linear scar on lower abdomen. The thinnest part of flap was 0.7cm in thickness. The size of the largest flap was 38 x 13 cm. The flaps were used in various types of skin and adipose tissue, adipose tissue only, and skin only according to the requirement of recipient site. CONCLUSION: The DIEP free flap was enough to provide a thin and huge flap for both breast and extremity reconstructions. It was able to provide versatile designs with sufficient adipose tissue. So we use it for 3-dimensional face and buttock contour reconstructions. The DIEP free flap is a valuable reconstructive donor for face, upper and lower extremity in addition to breast without compromising the integrity of abdominal wall.
Abdomen ; Abdominal Wall ; Adipose Tissue ; Breast ; Buttocks ; Cicatrix ; Diclofenac ; Epigastric Arteries ; Extremities ; Female ; Free Tissue Flaps ; Hematoma ; Humans ; Lower Extremity ; Male ; Mammaplasty ; Necrosis ; Seroma ; Skin ; Tissue Donors ; Upper Extremity

Phthirus pubis usually infests the pubis, groin, buttocks and perianal region. It can sometimes infest the thighs, abdomen, chest, axillae and beard. Eyelashes and eyebrows may be involved in children. The involvement of the scalp is very rare. We describe a case of P. pubis infestation located exclusively on the scalp in an adult woman. Neither lice/nits nor skin lesions were observed elsewhere, including eyebrows, eyelashes, axillae, pubis, buttocks and perianal region (the patient was hairless in the axillae and pubis). A review of the literature is enclosed.
Abdomen ; Adult ; Axilla ; Buttocks ; Child ; Eyebrows ; Eyelashes ; Female ; Groin ; Humans ; Phthirus ; Pubic Bone ; Scalp ; Skin ; Thigh ; Thorax

The purpose of this study was to explore the risk and pattern of injury which can happen to first time skier and snowboarder. From December 2006 to March 2008, questionnaires were provided to 7,786 patients injured from skiing or snowboarding and hospitalized. First time and experienced groups were distinguished through questionnaire and accidental reports. The differences in incidence, cause of injury, affected body region, type of injury, and severity of injury were compared between the two groups. Falling or slip down was the most common cause of injury in first timers, while collision with person was most common in experienced. Injured sites were similar in both ski and snowboard with arm and wrist as the most frequent injured body region. Sprain and contusion were the most common injury type for both groups. However, the incidence of ligament injury was higher in the first time skiers and concussion and dislocation in the first time snowboarders compared to the experienced. In conclusion, beginners in skiing and snowboarding happened to show different cause and features of injury compared to the experienced. Therefore beginners need effective programs differed from the ones of experienced, such as mentioning risks of skiing and snowboarding and reserving a porting of slopes to the beginners. Moreover, It is necessary to develop and effectively use protective gear in order to secure elbow joint and wrist eminence.
Arm ; Body Regions ; Contusions ; Dislocations ; Elbow Joint ; Humans ; Incidence ; Ligaments ; Surveys and Questionnaires ; Skiing ; Sprains and Strains ; Wrist

PURPOSE: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature since this entity was initially described by Keasbey in 1953 who called it calcifying juvenile aponeurotic fibroma. The tumor is a slowly growing, painless mass. In most cases the mass is poorly circumscribed and causes neither discomfort nor limitation of movement. Most lesions occur in children, with a peak incidence ages of 8-14 years. There is no evidence of any increased familial prevalence. Predilection sites are palm, finger, toe, but it also occurs in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. We herein describe a rare case of calcifying aponeurotic fibroma occurring on the chin with review of the literature. METHODS: A 14-year-old male had painless, slowly growing mass(phi2.5cm) on a chin for a year. The tumor was excised elliptically under local anesthesia and the excisional site was repaired directly. Due pathological examination was processed. RESULTS: Histological examination revealed an ill- defined fibrous growth that extends with multiple processes into the surrounding tissue with centrally located foci of calcification. The tumor is composed of short spindled plump fibroblasts with round or ovoid nuclei separated by collagenous stroma, showing vaguely palisading pattern. Diagnosis of calcifying aponeurotic fibroma was conferred. Postoperatively, the patient did well, and the lesion had not recurred. CONCLUSION: Fewer than 100 cases of calcifying aponeurotic fibroma have been reported in the literature. The most common occurring sites are palm, finger & toe, but it has been reported in the wrist, forearm, elbow, upper arm, neck, abdominal wall, lumbar paravertebral area, leg and ankle. Two cases of calcifying aponeurotic fibroma occurring on the neck have been reported in the literature. To the authors knowledge, our case of calcifying aponeurotic fibroma occurring on the chin is the first to be reported.
Abdominal Wall ; Adolescent ; Anesthesia, Local ; Animals ; Ankle ; Arm ; Child ; Chin ; Collagen ; Elbow ; Fibroblasts ; Fibroma ; Fingers ; Forearm ; Humans ; Incidence ; Leg ; Male ; Neck ; Prevalence ; Toes ; Wrist

OBJECTIVE: To evaluate the usefulness of ultrasonography as a follow-up tool for evaluating the effects of complex decongestive physiotherapy (CDPT) in breast cancer-related lymphedema (BCRL). METHODS: Twenty patients with BCRL were enrolled in this study. All patients had undergone therapy in the CDPT program for 2 weeks. Soft tissue thickness of both the affected and unaffected upper limb was measured before and after CDPT. The measurements were taken at 3 points (the mid-point between the medial and lateral epicondyles at the elbow level, 10 cm proximal and 10 cm distal to the elbow) with and without pressure. We then calculated the compliance of soft tissue before and after CDPT. Circumferences of both the affected and unaffected upper limb were also measured before and after CDPT at the 3 defined points. RESULTS: After 2 weeks of the CDPT program, the circumference and soft tissue thickness of the unaffected upper limb did not significantly change. In the affected upper limb, the circumference was significantly reduced in the 3 point, when compared with measurements taken prior to treatment. Additionally, soft tissue thickness was significantly reduced at the elbow and 10 cm proximal to the elbow. After CDPT, compliance at each of the 3 points had increased, but this trend was not significantly different. CONCLUSION: Our results showed that arm circumference and ultrasonography-derived soft tissue thickness was useful as a way of assessing therapeutic effects of CDPT.
Arm ; Breast* ; Compliance ; Elbow ; Follow-Up Studies ; Humans ; Lymphedema* ; Ultrasonography ; Upper Extremity

PURPOSE: In cases of high voltage electrical burns, a wound occurs as current enters or leaves the body and is accompanied by deep tissue injury. If upper extremity amputation is inevitable, consideration should be given to the residual limb functions, secondary reconstruction, and wearing of an upper prosthesis. Our hospital has achieved satisfactory outcomes through the use of a pedicled latissimus dorsi (LD) flap in patients undergoing transhumeral amputation and shoulder disarticulation due to upper extremity damage from high voltage electrical burns. METHODS: The study was targeted to five patients who suffered high voltage electrical burns, underwent above-elbow amputation, and were reconstructed in the acute and secondary phases using a pedicled LD flap from January 2005 to December 2011. All patients underwent equilateral pedicled LD flap surgery, with primary closure at the donating site. RESULTS: The average age of patients was 49.6 years (38~64); they were all male. One patient underwent sublayer skin grafting after a pedicled muscular LD flap, and four patients had a pedicled myocutaneous LD flap: one patient among the four had a forearm flap after the pedicled myocutaneous LD flap. All flaps were well adhered, and post-surgical flap reduction and local flaps were performed for adequate sizing and aesthetic improvement. CONCLUSION: In cases of upper arm amputation due to wide upper extremity damage caused by electrical burns, the use of the pedicled LD flap and adequate amputation length made subsequent wearing of a prosthesis possible. The pedicled LD flap procedure allowed reconstruction of a relatively large area of soft tissue and the surgery to the donating site was unproblematic.
Amputation ; Amputation Stumps ; Arm ; Burns ; Disarticulation ; Extremities ; Forearm ; Humans ; Male ; Prostheses and Implants ; Shoulder ; Skin Transplantation ; Upper Extremity

Though people occupationally exposed to machineries and automation in the industrialized society desire work involving decreased strength, due to the continuous and repetitive activities, a new industrial stress is present. Studies on prevalence of musculoskeletal disease and their related risk factors have evolved. In this study in relation to work tasks, we investigated the differences in musculoskeletal symptoms occurring in each body region. The results of the survey were as follows. 1. When comparing age, level of education, work duration, job satisfaction and leisure time activities according to work risk, age in control group was 32.83+/-5.5, in comparison to the other 2 groups was smaller(p<0.05), and level of education in control group was higher(p<0.05) Work duration in the cutting department as 8.04+/-4.99 years longer than the other 2 groups(p<0.05), but there was no difference in the job satisfaction and leisure time activities. 2. The mean of symptom scores of each work task was 1.54 in the cutting department, 1.57 in the press department and 1.59 in the control group, and there was no significant difference in the 3 groups. The mean of symptom scores for upper extremities in the control group was low but mo statistically significant difference was shown. 3. When comparing the mean of symptom score according to work task in the each body region, in the shoulder region, the symptom score in the press department which desired strength was higher than the other 2 groups but no significant difference was shown. In the wrist region the cutting department scored 1.01 and in comparison to the other 2 groups was significantly increased(p<0.05). 4. The results of the univariate regression analysis on the major individual risk factors associated with musculoskeletal symptom relating work showed that previous symptom complaints in the same body region was significant risk factor(p<0.001) in the whole body, Besides wrist, hip, and knee, psychological problem was shown to be a significant factor(p<0.05). And the body regions which work task was significant risk factor were wrist and neck region(p<0.05). 5. The results of the multiple regression analysis involving significant factors of each body region from the unfavorite regression analysis showed that previous symptom shoulder, elbow and lumbar region(p<0.001) and psychological problem in the shoulder, elbow and lumbar region(p<0.05) were significant factors, and work task was significant factor in the wrist(p<0.05).
Automation ; Body Regions ; Education ; Elbow ; Hip ; Job Satisfaction ; Knee ; Leisure Activities ; Musculoskeletal Diseases ; Neck ; Occupations ; Prevalence* ; Risk Factors ; Shoulder ; Upper Extremity ; Wrist

BACKGROUND: Syringoma is a benign tumor of eccrine origin which occurs predominantly in women after puberty. Although it is found commonly in the dermatological practice, studies relative to large series of patients have rarely been reported in the literature. OBJECTIVE: The purpose of this study is to describe general clinicopathologic features of syringoma and to compare clinical and histopathological features among various subtypes of syringoma. METHODS: A total of 80 patients with biopsy-confirmed syringoma were included. Data reviewed were sex, age, age at onset, subjective symptoms, family history, accompanied diseases, color and size, location and distribution, clinical impressions, treatment and course of the disease. Histopathologic features studied include acanthosis, basal pigmentation, tadpole appearance, vacuolization of tumor cells, keratin-filled cysts, calcification, and proliferation of fibrous stroma. RESULTS: Male: female ratio was 1: 4.7 and the mean age at onset was 29.1 years. The most frequent site of involvement was upper or lower eyelids (68.8%), followed by forehead, temple, cheeks, chin, abdomen, upper extremities, neck, vulva and penis, axillae, lower extremities, and perianal skin. Fifty patients showed localized lesions whereas the other thirty patients were classified as having eruptive, generalized syringoma. Twenty-one patients, most of them with vulvar syringomas, complained of itching. Seven patients had a family history of syringoma. Histopathologically, all the previously described features were found. Vacuolization of cells and keratin-filled cysts were not rarely seen and luminal calcification was found in 3 patients. Epidermal changes were associated with the presence of pruritus and stromal fibrosis was commonly found in patients with early onset or longer duration. Clinical and histological features were similar between localized group and generalized group, except for the common presence of brownish lesions in patients with generalized syringoma. Lesions were not resolved spontaneously and treatments were found to be unsatisfactory. According to the results, we conclude that syringoma manifests a wide variety of clinical and histopathological features and should be included in the differential diagnosis of various papular dermatoses.
Abdomen ; Adolescent ; Axilla ; Cheek ; Chin ; Diagnosis, Differential ; Eyelids ; Female ; Fibrosis ; Forehead ; Hospital Distribution Systems ; Humans ; Larva ; Lower Extremity ; Male ; Neck ; Penis ; Phenobarbital ; Pigmentation ; Pruritus ; Puberty ; Skin ; Skin Diseases ; Skin Manifestations ; Syringoma* ; Upper Extremity ; Vulva

BACKGROUND: Syringoma is a benign tumor of eccrine origin which occurs predominantly in women after puberty. Although it is found commonly in the dermatological practice, studies relative to large series of patients have rarely been reported in the literature. OBJECTIVE: The purpose of this study is to describe general clinicopathologic features of syringoma and to compare clinical and histopathological features among various subtypes of syringoma. METHODS: A total of 80 patients with biopsy-confirmed syringoma were included. Data reviewed were sex, age, age at onset, subjective symptoms, family history, accompanied diseases, color and size, location and distribution, clinical impressions, treatment and course of the disease. Histopathologic features studied include acanthosis, basal pigmentation, tadpole appearance, vacuolization of tumor cells, keratin-filled cysts, calcification, and proliferation of fibrous stroma. RESULTS: Male: female ratio was 1: 4.7 and the mean age at onset was 29.1 years. The most frequent site of involvement was upper or lower eyelids (68.8%), followed by forehead, temple, cheeks, chin, abdomen, upper extremities, neck, vulva and penis, axillae, lower extremities, and perianal skin. Fifty patients showed localized lesions whereas the other thirty patients were classified as having eruptive, generalized syringoma. Twenty-one patients, most of them with vulvar syringomas, complained of itching. Seven patients had a family history of syringoma. Histopathologically, all the previously described features were found. Vacuolization of cells and keratin-filled cysts were not rarely seen and luminal calcification was found in 3 patients. Epidermal changes were associated with the presence of pruritus and stromal fibrosis was commonly found in patients with early onset or longer duration. Clinical and histological features were similar between localized group and generalized group, except for the common presence of brownish lesions in patients with generalized syringoma. Lesions were not resolved spontaneously and treatments were found to be unsatisfactory. According to the results, we conclude that syringoma manifests a wide variety of clinical and histopathological features and should be included in the differential diagnosis of various papular dermatoses.
Abdomen ; Adolescent ; Axilla ; Cheek ; Chin ; Diagnosis, Differential ; Eyelids ; Female ; Fibrosis ; Forehead ; Hospital Distribution Systems ; Humans ; Larva ; Lower Extremity ; Male ; Neck ; Penis ; Phenobarbital ; Pigmentation ; Pruritus ; Puberty ; Skin ; Skin Diseases ; Skin Manifestations ; Syringoma* ; Upper Extremity ; Vulva