Pyoderma Gangrenosum is a rare disease whose etiology is probably autoimmune. We report two males aged 48 and 49 years and one female aged 54 years, with lesions in the right thigh, right leg and in the borders of a surgical incision in the chest. This article gives a brief description of the lesions, tips for diagnosis and help for the initial management and treatment.

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Use of a new cone shaped flap to cover skin defects. Experience in 108 patients Background: A new type of fasciocutaneous flap with the shape of an ice cream cone that is formed by locally rotated and V-Y advance flaps joined together, that can be used to cover complex defects, was developed. Previously, the irrigation of these flaps was ascertained in the legs of ten corpses. Aim: To report the results with the use of this type of ice cream cone shaped flap. Material and Methods: Retrospective analysis of 108 patients aged 20 to 52 years (99 males) in whom an ice cream cone shaped flap was used. Results: The defects covered were located in the leg in 27%, in the ankle in 10%, in the sole in 9%, in the heel in 8% and in other locations in the rest of patients. Eighty flaps (74%) had a good evolution, 11 (10%) had a major dehiscence, 13 (12%) had a minor dehiscence and 4 flaps (4%) had necrosis. Conclusions: This ice cream cone shaped flap is easy to use, safe and devoid of complications in most cases.

Treatment of trochanteric pressure sores with V-Y and tensor fasciae latae flapsBackground: Trochanter pressure sores can be treated with random, myocutaneous, fasciocutaneous or free flaps. Aim: To report the use of V-Y and tensor fasciae latae flaps for the treatment of trochanteric pressure sores. Material and Methods: Prospective study of 14 males and two females aged 24 to 64 years, with 17 sores. The surgical technique consisted in the design of a V shaped flap with irrigation in its superior base and lower vertex with one of its extremes in contact with the sore. A resection is made until a vital base is obtained, excising the prominent bone until a plane in which healthy tissue is seen. The flap is raised and rotated, covering the defect. A V-Y primary closure without tension is performed, leaving drainages that are withdrawn ten days later. Results: The complications recorded were three seromas, which were treated using a closed system with external and internal negative pressure. Two wound dehiscence episodes and two hematomas required a surgical correction. Conclusions: This type of flap is other therapeutic alternative for pressure trochanteric sores.