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Background The repair of an alar nasal defect is a frequent challenge for dermatologic surgeons for reasons of the high rate of non-melanoma cancers in the area. Objective Our aim was to describe the use of an east–west cheek-based flap (horizontal advancement flap) to repair a surgical defect on the nose ala. Methods Benefits and limits of this surgical procedure are evaluated. Result The resulting S-shaped scar was well-camouflaged among the natural skin lines (melolabial fold and melonasal junction). No architectural distortion of the nose resulted from the procedure. Conclusion In selected patients with small-to-medium-size defects of the nasal ala, the horizontal advancement flap is a simple, reliable and aesthetic reconstruction option.

Aims and Background In southern European countries, the availability of epidemiologic data on cutaneous malignant melanoma is limited. A descriptive analysis was performed on melanoma cases diagnosed in the Italian region of Romagna (population 600,000), 1986-91. Methods The main end point was the proportion of cases less than 1.5 mm thick by sex, age, and site. Results A total of 297 incident cases was evaluated. The average annual age-standardized (World) incidence rates were 6.2 (95% CI 5.2–7.2) per 100,000 females and 4.5 (95% CI 3.6–5.3) per 100,000 males. Females presented with significantly thinner melanomas than males. The proportion of cases less than 1.5 mm thick decreased significantly with increasing age in both sexes, with the most pronounced decrease (approximately from 2/3 to 1/3) being observed above 60 years for females and above 40 for males. Comparing sexes by 10-year age groups, a significant F:M advantage in thickness distribution was found only at age 40–49 and 50–59 years. Among females under 60, melanomas of the legs and those of the trunk showed no difference in thickness distribution, in both sexes, incidence appeared to increase progressively with age. No apparent elevation in incidence rates was observed in the age groups with the highest frequency of thin melanomas. Conclusions The major implication of these data is that in public education programs specific messages should be aimed at those subgroups that show the poorest levels of self-surveillance.

Background. Post-traumatic hematomas overlying the muscular fascia on the lateral aspect of the leg are common in elderly patients, particularly those receiving oral anticoagulant therapy. When large collections of blood accumulate within this region, the pressure within the hematomas may exceed the blood pressure in the dermal and subdermal vessels. Large areas of necrosis of the overlying skin may then result. Objective. To decrease the pressure of evolving and long-standing hematomas, thereby reducing inflammation and pain. Methods. Liposuction surgery was employed as a means of decompressing both evolving and long-standing hematomas. Results. Liposuction surgery has been found to be useful in the treatment of hematomas on the leg, and has the added benefit of producing cosmetically elegant results. An elastic compression bandage placed postoperatively reduces the risk of relapse. Conclusion. Liposuction surgery may be used to remove large leg hematomas without producing long and cosmetically unacceptable scars. The technique is easy to perform and permits rapid evacuation of hematomas, thereby minimizing patient discomfort.

Background Repairing dorsal nasal defects is a frequent challenge for dermatologic surgeons, mainly due to the high frequency of basal cell carcinomas on this site. Obvious scars, mismatched skin and distortion of the nasal contour are the surgical hazards that must be avoided in these cases. Aim Our aim was to perform surgery involving a simple flap in order to repair medium to large defects on the dorsal side of the nose. Methods The dorsal horizontal advancement flap was studied in 12 patients, in order to evaluate the benefits and limits of this surgical procedure. Results The resulting scars on most of our patients were well-camouflaged among their natural skin lines, and there was neither distortion of the alar contour nor the nostril. Conclusions This flap is easy to perform and, in selected cases, provides an outstanding alternative to second-intention healing, full-thickness skin grafts, transposition, rotation and pedicle flaps.

Background. The treatment of large, deep, postsurgical nasal tip defects presents a serious problem for skin surgeons and is generally dealt with by using complex flaps or skin grafts. Objective. The objective was to present the retroangular flap, a procedure that has only recently been described in literature. Methods. The retroangular flap technique is based on inverting the blood flow in the angular artery, a vessel that runs along the nasal groove just below the surface of the skin. Results. The retroangular flap is a single-step, easily performed, procedure that is usually carried out under local anesthesia. Conclusion. This technique can be used for the treatment of nasal tip defects and is a useful resource for skin surgeons.

A 45-year-old man from Nigeria in generally good health presented with a giant occipital neoformation approximately 8 × 8 cm. The lesion, exophytic, ulcerated, bleeding, and foul-smelling, had first appeared 4 months earlier and had grown rapidly. There was another similar, smaller lesion near the original one, which was presumed to be an intransit metastasis. Contrast-enhanced computed tomography and positron emission tomography scans confirmed that the patient had already developed lung, bone, and kidney metastases.