Neurofibromas are benign neoplasms originating from neural tissues that rarely transform into malignancies. Approximately 25% to 45% of neurofibromas are located in the head and neck; the most common sites are the lateral cervical region and mouth. A 27-year-old female patient visited our hospital complaining of a painful brownish mass in the right elbow that had recently increased in size. She had no history of cancer and was otherwise in excellent health. This mass accounted for 80% of the total elbow circumference. Genetic mutation testing resulted in a diagnosis of neurofibromatosis type 1. A wide surgical excision was performed, and the area was repaired using a bilateral large superficial circumflex iliac artery perforator free flap. The flap survived well, with no partial necrosis. Histological findings showed a plexiform neurofibroma measuring 14×12×1.5 cm3. The patient’s postoperative course was uneventful; at an 18-month follow-up, she had good cosmetic and functional outcomes with no signs of relapse.

Large defects in the buttock region are uncommon and pose significant challenges for reconstruction. The skin in this area adheres firmly to the subcutaneous tissue, making mobilization difficult. Attempts to use local or regional flaps to cover defects in this region often result in flap necrosis, leading to an elevated risk of infection and unstable wounds. In addition to these intrinsic challenges, factors such as fecal contamination, difficulty in patient positioning, and suboptimal underlying patient conditions further complicate the reconstruction process. Furthermore, the lack of suitable recipient vessels often hinders free tissue transfer for complex wound coverage in the buttock area. Here, we present a case involving sequential latissimus dorsi and omental free flap coverage to address a large gluteal skin and soft-tissue defect. Our experience highlights the importance of meticulous reconstructive planning and the appropriate selection of recipient vessels for successful buttock reconstruction.

Neurofibromas are benign neoplasms originating from neural tissues that rarely transform into malignancies. Approximately 25% to 45% of neurofibromas are located in the head and neck; the most common sites are the lateral cervical region and mouth. A 27-year-old female patient visited our hospital complaining of a painful brownish mass in the right elbow that had recently increased in size. She had no history of cancer and was otherwise in excellent health. This mass accounted for 80% of the total elbow circumference. Genetic mutation testing resulted in a diagnosis of neurofibromatosis type 1. A wide surgical excision was performed, and the area was repaired using a bilateral large superficial circumflex iliac artery perforator free flap. The flap survived well, with no partial necrosis. Histological findings showed a plexiform neurofibroma measuring 14×12×1.5 cm3. The patient’s postoperative course was uneventful; at an 18-month follow-up, she had good cosmetic and functional outcomes with no signs of relapse.

Large defects in the buttock region are uncommon and pose significant challenges for reconstruction. The skin in this area adheres firmly to the subcutaneous tissue, making mobilization difficult. Attempts to use local or regional flaps to cover defects in this region often result in flap necrosis, leading to an elevated risk of infection and unstable wounds. In addition to these intrinsic challenges, factors such as fecal contamination, difficulty in patient positioning, and suboptimal underlying patient conditions further complicate the reconstruction process. Furthermore, the lack of suitable recipient vessels often hinders free tissue transfer for complex wound coverage in the buttock area. Here, we present a case involving sequential latissimus dorsi and omental free flap coverage to address a large gluteal skin and soft-tissue defect. Our experience highlights the importance of meticulous reconstructive planning and the appropriate selection of recipient vessels for successful buttock reconstruction.

Neurofibromas are benign neoplasms originating from neural tissues that rarely transform into malignancies. Approximately 25% to 45% of neurofibromas are located in the head and neck; the most common sites are the lateral cervical region and mouth. A 27-year-old female patient visited our hospital complaining of a painful brownish mass in the right elbow that had recently increased in size. She had no history of cancer and was otherwise in excellent health. This mass accounted for 80% of the total elbow circumference. Genetic mutation testing resulted in a diagnosis of neurofibromatosis type 1. A wide surgical excision was performed, and the area was repaired using a bilateral large superficial circumflex iliac artery perforator free flap. The flap survived well, with no partial necrosis. Histological findings showed a plexiform neurofibroma measuring 14×12×1.5 cm3. The patient’s postoperative course was uneventful; at an 18-month follow-up, she had good cosmetic and functional outcomes with no signs of relapse.

Large defects in the buttock region are uncommon and pose significant challenges for reconstruction. The skin in this area adheres firmly to the subcutaneous tissue, making mobilization difficult. Attempts to use local or regional flaps to cover defects in this region often result in flap necrosis, leading to an elevated risk of infection and unstable wounds. In addition to these intrinsic challenges, factors such as fecal contamination, difficulty in patient positioning, and suboptimal underlying patient conditions further complicate the reconstruction process. Furthermore, the lack of suitable recipient vessels often hinders free tissue transfer for complex wound coverage in the buttock area. Here, we present a case involving sequential latissimus dorsi and omental free flap coverage to address a large gluteal skin and soft-tissue defect. Our experience highlights the importance of meticulous reconstructive planning and the appropriate selection of recipient vessels for successful buttock reconstruction.

Purpose: To identify the prevalence and risk factors of coronavirus disease 2019 (COVID-19) reinfection in patients with rheumatoid arthritis (RA). Materials and Methods: This study retrospectively analyzed patients with RA with a documented COVID-19 infection between January 2021 and December 2022 at a tertiary hospital in Seoul, South Korea. Reinfection was defined as a subsequent positive test result for severe acute respiratory syndrome coronavirus 2 at least 3 months after the initial infection. Cox proportional hazards models with backward elimination were employed to assess the association between potential risk factors and risk of reinfection. Results: Of 351 included patients with RA {female, 81.5%; median age, 58.0 years [interquartile range (IQR), 48.0–66.0]}, 252 (71.8%) were treated with methotrexate and 12 (3.4%) received leflunomide during the initial infection. Over a median follow-up of 1.5 (IQR, 1.1–1.6) years, 43 (12.3%) patients experienced reinfection, equating to an incidence rate of 8.97 per 100 patient-years.The median time interval between infections was 0.8 (IQR, 0.6–1.2) years. Among the risk factors, leflunomide use showed a significant association with reinfection (hazard ratio, 2.968; 95% confidence interval, 1.057–8.335; p=0.039). However, no significant changes occurred in disease activity following reinfection [disease activity score using 28 joints: baseline median, 2.3 (IQR, 1.9– 2.8); post-reinfection median, 2.3 (IQR, 1.8–2.6), p for change=0.895]. Conclusion In this retrospective cohort study of patients with RA with COVID-19 infection, approximately 12% of patients experienced reinfection without significant change in disease activity. Leflunomide use was associated with a higher risk of reinfection.

Purpose: To identify the prevalence and risk factors of coronavirus disease 2019 (COVID-19) reinfection in patients with rheumatoid arthritis (RA). Materials and Methods: This study retrospectively analyzed patients with RA with a documented COVID-19 infection between January 2021 and December 2022 at a tertiary hospital in Seoul, South Korea. Reinfection was defined as a subsequent positive test result for severe acute respiratory syndrome coronavirus 2 at least 3 months after the initial infection. Cox proportional hazards models with backward elimination were employed to assess the association between potential risk factors and risk of reinfection. Results: Of 351 included patients with RA {female, 81.5%; median age, 58.0 years [interquartile range (IQR), 48.0–66.0]}, 252 (71.8%) were treated with methotrexate and 12 (3.4%) received leflunomide during the initial infection. Over a median follow-up of 1.5 (IQR, 1.1–1.6) years, 43 (12.3%) patients experienced reinfection, equating to an incidence rate of 8.97 per 100 patient-years.The median time interval between infections was 0.8 (IQR, 0.6–1.2) years. Among the risk factors, leflunomide use showed a significant association with reinfection (hazard ratio, 2.968; 95% confidence interval, 1.057–8.335; p=0.039). However, no significant changes occurred in disease activity following reinfection [disease activity score using 28 joints: baseline median, 2.3 (IQR, 1.9– 2.8); post-reinfection median, 2.3 (IQR, 1.8–2.6), p for change=0.895]. Conclusion In this retrospective cohort study of patients with RA with COVID-19 infection, approximately 12% of patients experienced reinfection without significant change in disease activity. Leflunomide use was associated with a higher risk of reinfection.

Purpose: To identify the prevalence and risk factors of coronavirus disease 2019 (COVID-19) reinfection in patients with rheumatoid arthritis (RA). Materials and Methods: This study retrospectively analyzed patients with RA with a documented COVID-19 infection between January 2021 and December 2022 at a tertiary hospital in Seoul, South Korea. Reinfection was defined as a subsequent positive test result for severe acute respiratory syndrome coronavirus 2 at least 3 months after the initial infection. Cox proportional hazards models with backward elimination were employed to assess the association between potential risk factors and risk of reinfection. Results: Of 351 included patients with RA {female, 81.5%; median age, 58.0 years [interquartile range (IQR), 48.0–66.0]}, 252 (71.8%) were treated with methotrexate and 12 (3.4%) received leflunomide during the initial infection. Over a median follow-up of 1.5 (IQR, 1.1–1.6) years, 43 (12.3%) patients experienced reinfection, equating to an incidence rate of 8.97 per 100 patient-years.The median time interval between infections was 0.8 (IQR, 0.6–1.2) years. Among the risk factors, leflunomide use showed a significant association with reinfection (hazard ratio, 2.968; 95% confidence interval, 1.057–8.335; p=0.039). However, no significant changes occurred in disease activity following reinfection [disease activity score using 28 joints: baseline median, 2.3 (IQR, 1.9– 2.8); post-reinfection median, 2.3 (IQR, 1.8–2.6), p for change=0.895]. Conclusion In this retrospective cohort study of patients with RA with COVID-19 infection, approximately 12% of patients experienced reinfection without significant change in disease activity. Leflunomide use was associated with a higher risk of reinfection.

Purpose: To identify the prevalence and risk factors of coronavirus disease 2019 (COVID-19) reinfection in patients with rheumatoid arthritis (RA). Materials and Methods: This study retrospectively analyzed patients with RA with a documented COVID-19 infection between January 2021 and December 2022 at a tertiary hospital in Seoul, South Korea. Reinfection was defined as a subsequent positive test result for severe acute respiratory syndrome coronavirus 2 at least 3 months after the initial infection. Cox proportional hazards models with backward elimination were employed to assess the association between potential risk factors and risk of reinfection. Results: Of 351 included patients with RA {female, 81.5%; median age, 58.0 years [interquartile range (IQR), 48.0–66.0]}, 252 (71.8%) were treated with methotrexate and 12 (3.4%) received leflunomide during the initial infection. Over a median follow-up of 1.5 (IQR, 1.1–1.6) years, 43 (12.3%) patients experienced reinfection, equating to an incidence rate of 8.97 per 100 patient-years.The median time interval between infections was 0.8 (IQR, 0.6–1.2) years. Among the risk factors, leflunomide use showed a significant association with reinfection (hazard ratio, 2.968; 95% confidence interval, 1.057–8.335; p=0.039). However, no significant changes occurred in disease activity following reinfection [disease activity score using 28 joints: baseline median, 2.3 (IQR, 1.9– 2.8); post-reinfection median, 2.3 (IQR, 1.8–2.6), p for change=0.895]. Conclusion In this retrospective cohort study of patients with RA with COVID-19 infection, approximately 12% of patients experienced reinfection without significant change in disease activity. Leflunomide use was associated with a higher risk of reinfection.