[Downloaded free from http://www.jcasonline.com on Sunday, May 27, 2018, IP: 109.252.25.23] Correspondence
a benign asymptomatic condition and treatment is indicated only for cosmetic reasons. Complete excision is recommended as recurrence following ablative procedures, as in this case, has been reported.[5]
5.
6. 7.
Keshavmurthy A Adya, Aparna Palit, Arun C Inamadar Department of Dermatology, Venereology and Leprosy, SBMP Medical College, Hospital and Research Center, BLDE University, Vijapura, Karnataka, India. E-mail:
[email protected]
REFERENCES 1.
2.
3. 4.
Hoffman E, Zurhelle E. Über einen Nävus lipomatosus cutaneous superficialis der linken Glutealgegend. Arch Klin Exp Dermatol 1921;130:327-33. Bancalari E, Martínez-Sánchez D, Tardío JC. Nevus lipomatosus superficialis with a folliculosebaceous component: Report of 2 cases. Patholog Res Int 2011;2011:105973. Nakashima K, Yoshida Y, Yamamoto O. Nevus lipomatosus cutaneous superficialis of the vulva. Eur J Dermatol 2010;20:859-60. Vano-Galvan S, Moreno C, Vano-Galvan E, Arrazola JM, Muñoz-Zato E, Jaen P. Solitary naevus lipomatosus cutaneous superficialis on the sole. Eur J Dermatol 2008;18:353-4.
8.
9.
Kim YJ, Choi JH, Kim H, Nam SH, Choi YW. Recurrence of nevus lipomatosus cutaneous superficialis after CO2 laser treatment. Arch Plast Surg 2012;39:671-3. Weedon D. Tumors of fat. In: Weedon D, editor. Weedon’s Skin Pathology. 3rd ed. Edinburgh: Churchill Livingstone; 2010. p. 845-55. El-Zayaty S, Krausz T. Tumors of adipose tissue, muscle, cartilage, and bone. In: Barnhill RL, Crowson AN, Magro CM, Pipekorn MW, editors. Dermatopathology. 3rd ed. New York: McGraw Hill Professional; 2010. p. 857-83. Gupta K, Verneuil L, White CR Jr, Barnhill RL. Alterations of collagen and elastin. In: Barnhill RL, Crowson AN, Magro CM, Pipekorn MW, editors. Dermatopathology. 3rd ed. New York: McGraw Hill Companies Inc.; 2010. p. 387-407. Beer TW, Lam MH, Heenan PJ. Noninfectious erythematous, papular, and squamous diseases. In: Elder DE, Elenitsas R, Johnson BL Jr, Murphy GF, Xu X, editors. Lever’s Histopathology of Skin. 10th ed. Philadelphia: Lippincot Williams & Wilkins; 2009. p. 969-1005. Access this article online
Quick Response Code: Website: www.jcasonline.com
DOI: 10.4103/0974-2077.146686
Re: Superficial Large Basal Cell Carcinoma over the Face, Reconstructed by V-Y Plasty Dear Editor, Deshmukh et al. published a case of “Superficial large basal cell carcinoma over face, reconstructed by V-Y plasty”.[1] As the authors suggest, the VY flap is a very versatile option and is an excellent form of reconstruction on the face.[2] This however is a complex case for both oncological excision and reconstruction, and clearly documents the difficulties encountered in surgical excision and reconstruction in this area. The options for oncological excision include Mohs micrographic surgery (MMS), surgical excision with a margin and the use of intra-operative frozen sectioning. The reconstructive options include skin grafting and local flap reconstruction as a one-stage or two-stage procedure. For a large Basal cell carcinoma (BCC), oncological clearance is imperative prior to any reconstruction. MMS is the best method of establishing oncological clearance
while minimising the subsequent defect required for reconstruction.[3] Where MMS is not available, suitable surgical oncological clearance must be confirmed prior to definitive local flap reconstruction. In the absence of MMS. this is most commonly performed using frozen sectioning examination intra-operatively. Where surgical excision with a margin and reconstruction is required where oncological excision has not been confirmed intra-operatively. a skin graft — either split thickness or full thickness-is the best method of initial reconstruction from an oncological standpoint. This allows routine haemotoxylin and eosin assessment as used by the authors[1] to confirm oncological clearance. If oncological clearance is not achieved, a further excision can be performed easily subsequently. This is not the case when a re-excision is required with a local flap reconstruction where theoretically all the local flaps should be removed in the re-excision specimen. A local flap for a defect of this extent would not therefore be recommended as a one-stage reconstructive option without clarification of oncological clearance. As the authors suggest, a skin graft can lead to a contour
Journal of Cutaneous and Aesthetic Surgery - Jul-Sep 2014, Volume 7, Issue 3
183
[Downloaded free from http://www.jcasonline.com on Sunday, May 27, 2018, IP: 109.252.25.23] Correspondence
defect and is not the ideal aesthetic result. A skin graft however can be removed at a later stage using serial excision, tissue expansion or removal and replacement with a local flap, and clinicians need to be aware of all the oncological and reconstructive options available and the pros and cons of each option.
2.
3.
basal cell carcinoma over face, reconstructed by v-y plasty. J Cutan Aesthet Surg 2014;7:65-6. McCoubrey G, Ross GL. Subunits of the cheek: An algorithm for the reconstruction of partial-thickness defects. Br J Plast Surg 2004;57:478-9. Madan V. Re: Superficial large basal cell carcinoma over face, reconstructed by v-y plasty. J Cutan Aesthet Surg 2014;7:136-7.
Gary Ross
Access this article online Quick Response Code:
Department of Plastic Surgery, BMI The Alexandra Hospital, Cheshire, United Kingdom. E-mail:
[email protected]
Website: www.jcasonline.com
DOI: 10.4103/0974-2077.146688
REFERENCES 1.
Deshmukh P, Sharma YK, Dogra BB, Chaudhari ND. Superficial large
Re: Utility of Gel Nails Dear Editor, We would like to discuss the report on “Utility of gel nails”.[1] Nanda and Grover noted that “the use of Gel nails in patients with cosmetically disfiguring nail plate surface abnormalities (like trachyonychia, onychoschizia, pitting, etc.) was found to produce good to excellent improvement in most of the cases”.[1] Nanda and Grover also mentioned for no side-effect of gel nails. In fact, the present report by Nanda and Grover is on only a few cases. There are some other reports mentioned for the problem of gel nails. For example, Vázquez-Osorio et al. reported on allergic dermatitis due to acrylates in acrylic gel nails.[2] The problem of allergic dermatitis has to be kept in mind and investigated before using gel nails for cosmetic purposes. Contact dermatitis, asthma and allergy around the eyes and nose are notable adverse effects of artificial gel nails.[3] In addition, there are also other additional adverse effects.[3] Ill-fitting nails can lead to recurrent trauma and pyogenic granuloma.[3] At present, artificial nails have been banned in some healthcare set-ups citing carriage of harmful bacteria under the nail.
Sim Sai Tin, Viroj Wiwanitkit1 Medical Center, Shantou, 1Hainan Medical University, China E-mail:
[email protected]
REFERENCES 1.
2.
3.
Nanda S, Grover C. Utility of gel nails in improving the appearance of cosmetically disfigured nails: Experience with 25 cases. J Cutan Aesthet Surg 2014;7:26-31. Vázquez-Osorio I, Espasandín-Arias M, García-Gavín J, FernándezRedondo V. Allergic contact dermatitis due to acrylates in acrylic gel nails: A report of 3 cases. Actas Dermosifiliogr 2014;105:430-2. CDC -NIOSH Publications and Products. Controlling Chemical Hazards During the Application of Artificial Fingernails. Available from:http:// www.cdc.gov/niosh/docs/99-112/. [Last accessed on 2014 Aug 30]. Access this article online
Quick Response Code: Website: www.jcasonline.com
DOI: 10.4103/0974-2077.146690
Creating Recipient Sites Using Custom Cut Razor Blades in Hair Transplantation Dear Editor, refinements to achieve its current form.[1] An important step Follicular unit hair transplantation has undergone multiple in this surgery is the creation of recipient sites to receive
184
Journal of Cutaneous and Aesthetic Surgery - Jul-Sep 2014, Volume 7, Issue 3
