Pedicled Deep Inferior Epigastric Perforator Flap for Treatment of Dystrophic Epidermolysis Bullosa-Associated Squamous Cell Carcinoma in the Groin: Case Report.
- Author:
Kyung Pil KIM
1
;
Ji Hoon KIM
;
Eui Sik KIM
;
Jae Ha HWANG
;
Kwang Seog KIM
;
Sam Yong LEE
Author Information
1. Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea. pskim@chonnam.ac.kr
- Publication Type:Case Report
- Keywords:
Dystrophic epidermolysis bullosa;
Squamous cell carcinoma;
Perforator flap
- MeSH:
Adult;
Anesthesia, General;
Blister;
Carcinoma, Squamous Cell;
Cicatrix;
Electrons;
Epidermolysis Bullosa;
Epidermolysis Bullosa Dystrophica;
Follow-Up Studies;
Groin;
Humans;
Lymph Nodes;
Neoplasm Metastasis;
Parturition;
Perforator Flap;
Recurrence;
Skin;
Transplants;
Ulcer
- From:Journal of the Korean Microsurgical Society
2010;19(2):97-100
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Epidermolysis bullosa is a rare genetic disease, characterized by the presence of extremely fragile skin and formation of recurrent blister resulting from even a minor mechanical injury. Squamous cell carcinoma (SCC) is recognized as a complication of the chronic scarring associated with dystrophic epidermolysis bullosa (DEB). When a soft tissue defect happens in a patient with epidermolysis bullosa, it is difficult to cover it with a skin graft or a flap. We describe the successful use of a pedicled deep inferior epigastric perforator flap for the reconstruction of SCC associated with DEB in the groin. METHODS: A 29-year-old man diagnosed with DEB at birth sustained an ulcer increasing in the right groin for the last 7 months. Under general anesthesia, the mass lesion and lymph nodes were removed and the resulting defect was covered with a pedicled deep inferior epigastric perforator flap. RESULTS: The flap survived completely and his postoperative course was uneventful. Histopathological examination revealed a SCC in the right groin and malignant tumor cells in the removed lymph nodes as well. Additional positron emission tomogram showed a malignant lesion in the ileocecal area with regional lymph node metastasis. The patient was referred to an oncologist for chemotheraphy, but the patient refused to take it. During a 4-month follow-up period, there was no recurrence in the right groin. CONCLUSION: We suggest that perforator flaps can be considered as a reliable alternative for the reconstruction of soft tissue defects in a patient with DEB.
