A case of nevus sebceous of Jadassohn, which has developed on the frontal hair-line of scalp of 31 male patient since birth and associated with syrignocystadenoma papilliperum and basal cell carcinoma on excisional biopsy, showing soft yellowish 3.2*4com sized flat verucous plaque is reported.
Biopsy ; Carcinoma, Basal Cell* ; Humans ; Male ; Nevus* ; Parturition ; Scalp

A case of familial telangiectasia of face resembling lupus erythematosus but no having other involved symptoms, except ichthyosis vulgaris of lower legs in all 4 sisters, appeared on 8 months through 2 years after birth is reported Authors suggest this case to be simplified congenital telangiectasia of face, because of not consisted with preexistiong various diseases such as Bloom's syndrome, Ataxia-Telangiectasia, Rothmund-Thomsons' Syndrome, Dyskeratosis congenita, and Cockayne's syndrome, which show the familial telangiectasia of face.
Ataxia Telangiectasia ; Bloom Syndrome ; Dyskeratosis Congenita ; Humans ; Ichthyosis Vulgaris ; Leg ; Parturition ; Siblings ; Telangiectasis*

The surgical treatment of long duration lagaphthalmos was traditionally conducted using the Gillies (1934) method of temporal muscle transfer. This method has been effective in cases of simultaneous lagaphthalmos in the upper eyelid and ectropion in the lower eyelid. In the past, we treated 18 leprosy patients who suffered complications of ptosis in the upper eyelid and ectropion in the lower eyelid after the application of the Gillies method. To treat these complications, we removed the fascia strips emplaced during temporal muscle transfer from the upper and lower eyelid. Thereafter, we implanted a 1.0 gram gold plate in the upper eyelid and either a conchal cartilage graft. In the treatment of Lagaphthalmos over the past seven years, we have applied gold plate lid loading in 120 cases. However, in five of these cases, patients suffered from exposure of the gold plate due to paralytic orbicularis oculi muscle tearing. Recently, to correct this, we covered the gold plate with AlloDerm tissue to protect and support the muscle. In the treatment of ectropion over the last six years, we have had over 30 cases of cartilage grafts (over 35mm in length and 5mm in breadth) in the lower eyelid. However, the end of the cartilage graft would warp and create new partial ectropion several months later. Because of this, we shifted from cartilage to AlloDerm. We applied 40mm (length) and 7mm (breadth) to the lower border of the tarsus and fixed at each end with medial and canthal ligament. From 1997 to 2002, in the Institute of Leprosy Research, we operated on 25 patients suffering from Lagaphthalmos and Ectropion using a newer treatment to correct ectropion more effectively. The levator muscle of the upper eyelid loses the funtion of its antagonistic muscle, namely the orbicularis oculi due to facial nerve palsy, and results in retraction of the upper eyelid. To correct upper eyelid retraction, we severed the levator and muller muscle from the superior tarsal border and discontinued the use of gold lid loading which is visually evident. This method does not result in ptosis and the eye is more normal in appearance.
Ankle ; Cartilage ; Ectropion ; Eyelids* ; Facial Nerve ; Fascia ; Humans ; Leprosy ; Ligaments ; Paralysis ; Temporal Muscle ; Transplants

Axillary osmidrosis, also referred to as bromhidrosis, is a condition of excess, abnormal, or strong acrid body odor that typically manifests itself after puberty with the enlargement of apocrine glands. This condition often causes the affected to avoid social settings and personal relationships particularly throughout puberty and into adult life. The surgical objectives for treating axillary osmidrosis are to eliminate malodor and postoperative recurrence, to reduce significant complications such as hematoma and skin flap necrosis causing scarring, to decrease the recovery time, and to reduce the surgical scars. In order to meet the objectives, I recommend to use three surgical methods such as subdermal shaving method with scissors, liposuction and curettage method, and curettage and dermal shaving with manual and electric bone rasp. The subdermal shaving method demands the surgeon to execute meticulous hemostasis in the central axilla. Quilting sutures should be placed to fixate the skin flap to the axillary base to further prevent hematoma and to shorten recovery time. A relatively simple pressure dressing is removed after a couple of days, which will allow the patients to resume their routine daily life. Liposuction and curettage method is used to remove the apocrine glands in the subcutaneous layer. Apocrine and eccrine glands in the lower dermis are removed by dermal shaving with a manual or electric bone rasp or by a suction assisted cartilage shaver.
Adolescent ; Adult ; Apocrine Glands ; Axilla ; Bandages ; Cartilage ; Cicatrix ; Curettage ; Dermis ; Eccrine Glands ; Hematoma ; Hemostasis ; Humans ; Lipectomy ; Necrosis ; Odors ; Puberty ; Recurrence ; Skin ; Suction ; Sutures

A statistical observations were made on total 79 In-Patients in the departments of dermatology, Dongsan Presbyterian Hospital, Kyungpook National University and Fatima Hospital, Taegu, Korea during the period from Sept. 1, 1975 to August 31, 1976.
Daegu* ; Dermatology* ; Gyeongsangbuk-do* ; Korea* ; Protestantism*

No abstract available.
Blepharoptosis*

BACKGROUND: Damage of the facial nerve, especially buccal and marginal mandibular branches, causes facial palsy and paralytic deformity of the lips such as lower lip ectropion, lip drooping, deviation of the mouth, inability of closing mouth, and the loss of the nasolabial folds. OBJECTIVE: To find out the best surgical method to correct paralytic deformity of the lips. METHODS: We reviewed retrospectively the various surgical treatment modalities of the paralytic deformity of the lips performed in The Institute for Leprosy Research for 13 years. RESULTS: One hundred and twenty five surgical procedures were performed in 80 patients with Hansen's disease. Of these, the static method, dermal suspension flap, was done in 15 cases, the dynamic methods were done in 64 cases, and others were done in 46 cases. All patients showed postoperatively clinical improvement above the average. Two patients received reoperation or additional procedures due to relapse of the condition. CONCLUSIONS: The dynamic method using tensor fascia lata was superior to other treatment modalities.
Congenital Abnormalities ; Ectropion ; Facial Nerve ; Facial Paralysis ; Fascia Lata ; Humans ; Leprosy ; Lip ; Mouth ; Recurrence ; Reoperation ; Retrospective Studies

Facial nerve paralysis in leprosy adversely affects facial regions from the forehead to the lip. In particular, lagophthalmos in patients with leprosy causes exposure keratitis, corneal and conjunctival dryness which can progress blindness and disfigurement. The function of the eyelids is controlled by the oculomotor nerve and the facial nerve. In leprosy patients the oculomotor nerve continues to function causing the levator muscle to lift the eyelids. However, paralysis of the facial nerve prevents the orbicularis oculi muscle from closing the eyelids, resulting in lagophthalmos. Various methods were developed to correct lagophthalmos, one of which was temporal muscle transfer(TMT) reported in 1934 by Gillies. Since we noted relatively high occurrence of ptosis as a complication in patients treated previously with the TMT, we performed other surgical procedures for laglphthalmos over 15 years, not to make the ptosis. Although most of the patients quite improved post-operatively, partial lid-gap frequently persisted. It may be related to involutional changes and paralyzed orbicularis muscle. Recently, we conducted 4 different TMT methods for last 4 years to reduce ptosis. The methods used included Brown & McDowell, McCord & Codner, modified Gillies & Anderson, and modified Gillies. Seventy-five TMT operations in 60 patients(26 males and 34 females) were done between 2011 and 2014. The age range of the patients was 54~87 years(the mean was 70.1). Fifteen patients had bilateral TMT procedures. As a result, ptosis appeared in 14(18.7%) out of 75 TMT procedures for 4 years. Four technical points should be considered for the initial assessment to prevent or reduce the incidence of ptosis. The first is the increase of the length of temporalis muscle flap to approximately 8cm with a parallel course to the lateral canthus, which will reduce the oblique pull. Second, the width of the fascia sling in the upper eyelid is narrow(3~4mm) to reduce weight on the eyelid. Third, the fascia sling in the upper lid is not tied with that of the lower lid at the medial canthal tendon to reduce tension. Lastly, the fascia sling in the upper eyelid is shallow(subdermal level) in location and as near as possible to the lid margin.
Aged ; Blindness ; Eyelids ; Facial Nerve ; Fascia ; Forehead ; Humans ; Incidence ; Keratitis ; Leprosy* ; Lip ; Male ; Oculomotor Nerve ; Paralysis ; Temporal Muscle* ; Tendons

The imbalance between paralyzed orbicularis oculi and normally functioning its antagonists such as the levator of the upper lid and the capsulopalpebral fascia of the lower lid in patients with leprosy causes ectropion, eyelid retraction and lagophthalmos. There are a lot of surgical methods to manage the ectropion and retraction of the lower lid including lateral canthoplasty, lateral canthopexy, spacer graft, canthal sling, medial tarsorraphy as well as temporal fascia transfer. In this study, we applied the lateral tarsal strip combined with Kuhnt- Szymanowski procedure to thirty-two patients with paralytic ectropion and this method was proven to be very effective in correcting the abnormal conditions.
Ectropion ; Eyelids ; Fascia ; Humans ; Leprosy ; Transplants

Lepra bacilli invade the nasal mucosa from early stage. The infiltrated mucous membrane breaks down and ulcerates easily. Irritating crusts and ulcers occur, creating in perforation of the septum. When most of the septum and inner mucosal lining of the nose is destroyed, the nose is deprived of its support and it collapses. The nasal bones are typically intact, and the collapsed nose adheres to the facial skeleton, giving the characteristic 'sunken and short nose' deformities. We have operated on 25 patients with deformities such as short nose, sunken nose, collumela deformity and ala collapse since 1992. In short nose we operated with a paramedian forehead flap and rib cartilage graft in a cantilever pattern. In ala collapse we used a conchal cartilage graft. Lastly, in collumela deformity we used the local flap and a composite graft.
Cartilage ; Congenital Abnormalities* ; Forehead ; Humans ; Leprosy* ; Mucous Membrane ; Nasal Bone ; Nasal Mucosa ; Nose ; Ribs ; Skeleton ; Transplants ; Ulcer