This study confirms anecdotal and retrospective reports that streptococcal throat infections can cause exacerbation of chronic plaque psoriasis. It is concluded that psoriasis patients should be encouraged to report sore throat to their physician and that early treatment of streptococcal throat infections might be beneficial in psoriasis. A controlled trial for assessing potential benefits of tonsillectomy in patients with severe psoriasis should also be considered.

Women who suffer from breast hypertrophy commonly have physical symptoms such as back pain and psychosocial problems. Breast reduction surgery is performed to relieve these problems. Side-effects must be kept to a minimum. Risk factors for developing postoperative complications have not clearly been identified so far. The aim of this study was to identify risk factors that lead to complications. The medical records of 512 consecutive women (mean age 40 years) who underwent bilateral breast reduction were retrospectively studied. All complications that occurred during the first 30 days after the operation were retrieved from medical records. Complications occurred in 32% of the patients within 30 days of surgery. The most common complication was infection at the surgical site (16%) followed by delayed wound healing (10%). Fat necrosis occurred in 2.5%, partial areola necrosis in 3.1%, and total areola necrosis in 0.6% of the patients. A longer suprasternal notch to nipple distance gave significantly higher risk of postoperative infection (p < 0.001) and necrosis in the mammilla (p < 0.001). The resected specimen weight during the operation was found to significantly influence the risk of delayed wound healing (p = 0.021) and fat necrosis (p < 0.001). Smokers had twice the risk of getting a postoperative infection, RR = 2.0 (95% CI = 1.3-3.1). Diabetics had a significantly higher risk of necrosis of the areola (p = 0.003). All the above predictors were identified as independent predictors. Complications after breast reduction are common. The study has identified several risk factors for complications, some of them independent, which might be avoidable by performing a careful preoperative evaluation of the patient.

Meticulous registration of incidence of different complications in five different breast reconstruction methods revealed high complication rates with all methods. The differences in incidence of complications were related to the operation method used. Based on these results, careful individual planning of a breast reconstruction is mandatory.

Introduction Breast hypertrophy is a condition associated with physical, psychological, and psychosocial problems. The primary aims of this study were to determine the impact of breast hypertrophy and the effects of breast reduction, performed on the basis of well-described inclusion criteria, on general and breast-related health, using both general and diagnosis-specific validated questionnaires. We used a prospective, longitudinal paired study design. A secondary aim was to analyze the relationship between preoperative breast volume, body mass index, sternal notch-to-nipple distance and the weight of resected tissue on the one hand and improvements in health on the other. Methods Three hundred forty-eight consecutive patients undergoing breast reduction were included and the Short-Form 36 (SF-36), Breast-Related Symptoms Questionnaire (BRSQ), Modified Breast Evaluation Questionnaire (mBEQ) and BREAST-Q were distributed preoperatively and 1 year postoperatively. Results A total of 284 (83%) patients answered the questionnaires either preoperatively or postoperatively, or both, and 159 (46%) patients answered both. The breast hypertrophy patients had significantly lower scores preoperatively than the matched normal population when it came to all dimensions of the SF-36 and mBEQ. The preoperative scores for both the BRSQ and BREAST-Q were low. After breast reduction, there were significant improvements in all dimensions of the BRSQ, mBEQ, and Breast-Q and in several dimensions of the SF-36. Conclusions Breast reduction reduces or removes disease-associated pain. It improves or normalizes perceived health and psychosocial self-esteem in slightly obese women or women of normal weight with preoperative breast volumes around 1000 mL. Women with higher preoperative breast volumes and longer sternal notch-to-nipple distances appear to be more satisfied with the cosmetic result postoperatively.