Phaeohyphomycosis of the Hand Treated Using Mohs Micrographic Surgery

Tran, An Vu; Boyer, Julien

doi:10.1111/dsu.12225

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…[3][4][5] None used a skin graft, but rather allowed second intention healing. There are 3 previous reports of cutaneous phaeohyphomycosis treated with Mohs surgery.…”

Section: Discussionmentioning

confidence: 99%

Refractory Cutaneous Alternariosis Successfully Treated With Mohs Surgery and Full-Thickness Skin Grafting

Simpson

Craig-Muller

Sobanko

et al. 2016

Dermatologic Surgery

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anchor stitch at the beginning. 4 Perform an initial anchor stitch and leave a long tail as described above. Complete the rest of the closure as normal and after the final bite is performed, cinch the wound down as taught as possible. Attach a hemostat to the suture where it exits the dermis ( Figure 2) and then perform an instrument tie, tying the free end of the suture to the long tail of the anchor stitch. This modification maximizes the cinching of the purse and allows for the knot to be thrown without tension, allowing for better knot security.Purse-string closures reduce wound size by 50% to 78%, and the buried purse-string suture technique is a good closure option for defects created by dermatological surgery in certain situations. 1 The "purse-string anchor" modification of this technique that the authors have described above allows for better knot security with less slipping during the instrument tie. The purse-string anchor is technically easy and can be combined with the purse-string lockdown to maximally reduce the circumference of a circular defect, providing both security and strength. References 1. Cohen PR, Martinelli PT, Schulze KE. Nelson BR the purse-string revisited: a useful technique for the closure of cutaneous surgical wounds. Int J Dermatol 2007;46:341-7. 2. Weisberg NK, Greenbaum SS. Revisiting the purse-string closure: some new methods and modifications. Dermatol Surg 2003;29:672-6. 3. Harrington AC, Montemarano A, Welch M, et al. Variations of the purse string suture in skin cancer reconstruction.The frequency of opportunistic fungal infections is rising among a growing population of immunosuppressed patients. In this letter, the authors report a case of recurrent cutaneous alternariosis treated with Mohs surgery and the first case in which a graft was used.A man in his sixties with diabetes, status post cardiac transplant on tacrolimus, prednisone, and mycophenolate, presented with a nodule on the finger that enlarged for more than 2 months. The patient did not recall any preceding trauma, although he enjoyed gardening. Figure 1. A knot is tied on the first throw, and a long tail is left when the suture is cut. This knot serves as the anchor as subsequent throws are performed. Figure 2. A variation of the purse-string lockdown using an anchor stitch. The purse is cinched down and a hemostat is placed at the free end where the suture exits the dermis.

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“…[3][4][5] None used a skin graft, but rather allowed second intention healing. There are 3 previous reports of cutaneous phaeohyphomycosis treated with Mohs surgery.…”

Section: Discussionmentioning

confidence: 99%

Refractory Cutaneous Alternariosis Successfully Treated With Mohs Surgery and Full-Thickness Skin Grafting

Simpson

Craig-Muller

Sobanko

et al. 2016

Dermatologic Surgery

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“…1 A case report on the use of MMS for the treatment of phaeohyphomycosis of the hand has also been published. 70…”

Section: Mohs Micrographic Surgery For Rare Skin Malignanciesmentioning

confidence: 99%

Mohs Micrographic Surgery: Development, Technique, and Applications in Cutaneous Malignancies

Chen

Srivastava

Nijhawan

2018

Seminars in Plastic Surgery

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Mohs micrographic surgery (MMS) is a specialized technique for treating skin malignancies that offers the highest cure rate by allowing histological evaluation of the entire peripheral and deep margins. MMS also maximally preserves as much uninvolved, normal adjacent tissue as possible, allowing for the best cosmetic and functional outcomes. When used for appropriate indications, this technique is also more cost-effective than other treatment modalities. In this article, the authors will discuss the development of MMS, the steps involved in this procedure, and the indications for this technique. They will also review the use of MMS for basal cell carcinoma, squamous cell carcinoma, melanoma in situ, and some less common skin malignancies.

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Beyond Skin Tumors: A Systematic Review of Mohs Micrographic Surgery in the Treatment of Deep Cutaneous Fungal Infections

et al. 2020

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BACKGROUND Deep cutaneous fungal infections (DCFIs) can cause significant morbidity in immunocompromised patients and often fail medical and standard surgical treatments because of significant subclinical extension. Although rarely considered in this setting, Mohs micrographic surgery (MMS) offers the advantages of comprehensive margin control and tissue conservation, which may be beneficial in the treatment of DCFIs that have failed standard treatment options. OBJECTIVE To review the benefits, limitations, and practicality of MMS in patients with DCFIs. METHODS A systematic review of PubMed and EMBASE was conducted to identify all cases of fungal skin lesions treated with MMS. RESULTS Eight case reports were identified consisting of a total of 8 patients. A majority of patients had a predisposing comorbidity (75%), with the most common being a solid organ transplant (n = 3, 37.5%). The most commonly diagnosed fungal infection was phaeohyphomycosis (n = 5, 62.5%), followed by mucormycosis (n = 2, 25%). No recurrence or complication post-MMS was noted at a mean follow-up of 11.66 months. CONCLUSION Although not a first-line treatment, MMS can be considered as an effective treatment alternative for DCFIs in cases of treatment failure and can be particularly helpful in areas where tissue conservation is imperative.

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Phaeohyphomycosis of the Hand Treated Using Mohs Micrographic Surgery

Cited by 3 publications

References 6 publications

Refractory Cutaneous Alternariosis Successfully Treated With Mohs Surgery and Full-Thickness Skin Grafting

Refractory Cutaneous Alternariosis Successfully Treated With Mohs Surgery and Full-Thickness Skin Grafting

Mohs Micrographic Surgery: Development, Technique, and Applications in Cutaneous Malignancies

Beyond Skin Tumors: A Systematic Review of Mohs Micrographic Surgery in the Treatment of Deep Cutaneous Fungal Infections

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