Squamous cell carcinoma (SCC) of the scrotum was one of the first occupational diseases to be described, and acquired its eponym from Sir Percivall Pott. The condition has now become rare owing to the establishment of industrial health norms. A 45-year-old male with a history of long-term exposure to petrochemicals presented to our institution with a scrotal lesion and underwent wide-local excision of the same. Histopathology revealed well-differentiated SCC involving the epididymis. Treatment options included excision with ilio-inguinal bloc dissection (in the event of lymphadenopathy) with subsequent chemotherapy and/or radiotherapy. Tumors following occupational exposure thus continue to contribute to the rapidly decreasing incidence of scrotal carcinoma.
Background Abnormalities of fingernail growth and appearance are among the most common deformities encountered after burn injury to the hand. Various techniques used for resurfacing defects include incision of the scarred eponychium and advancement of the distal segment, flap reconstruction-distally, and proximally based transposition/advancement flaps, composite graft techniques, microvascular transfer. In the present study, we used an onion flap to release scarred eponychium and nail fold reconstruction in a single stage without using soft tissue from another area.
Materials and methods Forty-four burnt fingers were operated using Yang's onion flap technique. Patients were assessed for flap necrosis, hematoma and infection in the early postoperative period and for donor site scar, nail appearance, and symptomatic relief in a follow-up for at least 4 months.
Results The flap was successfully performed on all fingers. Only two fingers had flap necrosis. There was no incidence of hematoma or infection. The donor site scar and nail plate appearance improved and was acceptable to most patients after surgery. There was also significant relief in daily activities in 19 out of 28 symptomatic patients.
Conclusion Yang's flap to correct nail deformities in burn patients is feasible in Indian scenario. It is associated with a low complication rate and improved nail appearance. There is also significant symptomatic relief in performing daily activities after surgery.
Context:
Keloids and hypertrophic scars are a cause of severe impairment of quality of life. Intralesional triamcinolone acetonide has been used at different intervals at various centers.
Aim:
This study was aimed to compare the efficacy of intralesional triamcinolone acetonide at 2-, 4-, and 6-week intervals in hypertrophic scars and keloids.
Settings and Design:
This study was conducted in the plastic surgery outpatient department of a tertiary care hospital. This is an interventional prospective study, randomization was done using a computer-generated sequence.
Materials and Methods:
In this study conducted from October 2015 to January 2017, administration of triamcinolone acetonide 40 mg/ml at 2-weekly, 4-weekly, and 6-weekly intervals was done in case of hypertrophic scars and keloids for up to 8 doses or till Vancouver Scar (VCS) scale of 4 was achieved. VCS, pain, and itching were noted and compared.
Statistical Analysis:
VCS scale was used for comparison using analysis of variance test. The visual analog scale was compared using an unpaired t-test. Qualitative data were compared using the Chi-square test/Fischer's exact test. P < 0.05 was considered statistically significant.
Results:
The 2-weekly regimen was found to show better results in terms of pain and scar improvement. It also required a lesser number of doses to produce the same effect. The response to itching was comparable in 2- and 4-weekly groups and was better than 6-weekly group. Minimal complications were noted in the three groups.
Conclusion:
Two-weekly regimen of triamcinolone acetonide is recommended for intralesional use in hypertrophic scars and keloids.
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