Depressed forehead scars are not frequently reported in the literature in the West African sub-region. Although they are not commonly reported, few cases were managed and are to be documented. We had seen a case of depressed forehead scar which was due to post frontal avulsion injury of the forehead with an intact posterior table of the frontal bone. He complained of aesthetic and psychological problems of the scar on presentation. The scar revision was done with polymethylmethacrylate bone cement with simple wound closure based on patient’s choice after counseling. The treatment outcome was satisfactory. We intend to highlight the use of polymethylmethacrylate bone cement and simple wound closure as an option in the revision of depressed forehead scars as well as add a report to the volume of literature from the sub-region.

Introduction: Pseudoepitheliomatous hyperplasia is a benign condition characterized by hyperplasia of the epidermis and adnexal epithelium commonly occurring in reaction to several conditions including chronic burn wound. Case Report: An 18 month old male patient presented with scald burns to the scalp and face with chronicity and infection of the burn wound as consent for skin grafting was not given by the parents. Initial histology of incision biopsy specimen revealed a well-differentiated squamous cell carcinoma in a chronic burn wound on the scalp. This did not correlate with the clinical picture of the wound necessitating a second histologic review of the biopsy specimen, which this time was confirmed as pseudoepitheliomatous hyperplasia. Patient further declined excision and grafting with the wound eventually healing with scarring after 10 months. Conclusion: A very high index of suspicion is required in making the diagnosis of PEH. Public enlightenment is needed to educate people on wounds and their management if optimal results must be obtained.

Erysipelas, a variant of cellulitis, is a superficial dermal bacterial infection. This superficial cutaneous infection may cause lymphangitis with resultant lymphedema in poorly treated cases. Reports of erysipelas preceding lymphedema are rare, rather many have reported the occurrence of erysipelas in patients with subclinical or overt lymphedema. Two case reports of erysipelas preceding lymphedema after appropriate parenteral antibiotics therapy and limb elevation are here presented. Following diagnosis, admission, and commencement of therapy, the second patient (Case 2) discontinued hospital treatment halfway for native treatment and returned after about 3 weeks. All patients recovered successfully but later presented with lymphedema after 8 weeks and 6 weeks, respectively. Both patients made a sustained functional recovery of their limbs with conservative management including elastic compression stocking and limb elevation. Erysipelas infection preceding lymphedema may develop when it occurs, prompt and appropriate treatment modalities for erysipelas infection may forestall the development of lymphedema.

Injuries to the fingertip are common in our Accident and Emergency Department. The goal of treatment is restoration of a painless, functional digit with protective sensation. In other words, it involves the provision of sensate and durable fingertip and bone support for nail growth. When selecting a treatment option the amount of soft-tissue loss, the integrity of the nail bed, the age and physical demands of the patient should be considered. The study seeks to evaluate the mechanisms and management of fingertip amputations including the treatment modalities used and its impact on patient outcomes. This is a prospective study of 37 patients with 43 cases of fingertip amputations. Patient ages ranged from 5 to 56 years. Data was collected from January, 2016 to December, 2017. Various reconstructive options were considered for the fingertip amputations such as skin grafting, cross finger flap, thenar flap, hypothenar flap, louvers flap and groin flap in multiple digital injuries. The total duration of treatment varied from two to seven weeks with follow-up of two to eight months. The results showed preservation of finger length and contour, retention of sensation and healing minimal complication. About 40% of the patients had well formed fingertip pulps which were aesthetically acceptable. In conclusion, fingertip amputation is a common injury. Treatment depends on how much skin, soft tissue, bone and nail were damaged and how much of the finger or thumb was cut off. A good knowledge of the mechanism of injury, type of injury, occupation of patient and hand dominance would help in deciding the surgical technique to use. A satisfactory reconstruction is ascertained if the patient has durable, sensate, fingertip length preservation and a fairly formed pulp.

Lip reduction is a plastic surgery procedure that enhances facial appearance by reducing the volume of   lower, upper or both lips. This procedure finds its usefulness in the present day lip reduction plasty as a form of cosmetic surgery. We present a 28-year- old female who complained of broad lips with a portion of red (wet) vermilion exposed when the mouth was closed. We present this rare aesthetic surgical procedure in our hospital and also a search of relevant literature. Level of Evidence: level 1V