Dermatologic diseases in patients with AIDS

This short review deals with the cutaneous manifestations of the acquired immune deficiency syndrome (AIDS), which comprise Kaposi's sarcoma, as an important marker disease for AIDS, as well as various skin infections caused by bacteria, fungi and viruses. In patients at risk of acquiring AIDS, an extensive immunological investigation should be performed if skin infections are established. In addition, a large number of cutaneous complications encountered in AIDS patients have an immunological background, e.g. an extreme hypersensitivity to trimethoprim-sulfamethoxazole. Therefore, the dermatological investigation of patients at risk of acquiring AIDS is urgently recommended as a regular part of the general check-up.     

Closing surgical defects of the external ear

Closing surgical defects of the external ear poses unique challenges because of the convoluted shape and thin tethered skin. Choice of repair is often dictated by the site of the wound. If the defect is central and anterior with intact cartilage, most defects will do well by second intention healing or grafting. If the defect involves the helical rim, reconstruction is often preferred to maintain the normal curvature of the external ear and a helical rim advancement flap with trimming of the central cartilage is often used. Defects of the posterior ear where the skin is more abundant and loose can often be closed side to side. Split earlobes may be repaired by Z-plasty. The full range of repair options should be considered in every case. Because each ear differs in shape and flexibility, creativity is warranted, rewarding both the patient and the surgeon.     

Surgical treatment of tumors of the external ear

In the years 1974-1988 in the Department of Otorhinolaryngology Medical Academy in Cracow 60 patients were treated surgically for malignant tumours of the auricle. Their mean age was 61.9 years, males prevailed (82%). In 1 case the malignant lesion involved also the external auditory meatus and in 4 cases it spread to the skin near the auricle. Histological examinations demonstrated basal cell carcinoma in 22 cases (37%), spinocellular carcinoma in 31 cases (52%), basal-spinocellular carcinoma in 6 cases (10%) and malignant melanoma in 1 case. In 3 cases of spinocellular carcinoma metastases to lymph nodes were found. In 30 cases partial amputation of the auricle was done, in one of them recurrence developed after over 5 years. Advanced malignant lesions in 30 cases required extensive operation with removal of the lesion within margins of healthy tissue, removal of lymph nodes with metastases and one-step plastic operation. Recurrences developed in 2 cases. Hyperkeratotic foci near the malignant tumour were present in 64% of these patients. They made difficult preoperative qualification and required more extensive excision of the neoplasm. After tumour removal from the external meatus the resulting tissue defect must be filled with a skin graft since healing by granulation tissue development leads to obliteration of the meatus. Two out of 7 patients required additional interventions for maintenance of the patency of the meatus.     

Dermatologic diseases and their effects on male sexual functions

Chronic skin diseases may result in a variety of psychological problems, including distress, demoralization, poor self esteem, sleep disturbances, social phobia, anxiety, depression and obsessive‐compulsive disorder. It is known that skin diseases may also cause sexual problems. Sexual activity remains important for most men throughout their adult lives and into old age. Impairment in their sexual experience can cause significant personal and interpersonal distress at any age. Sexual dysfunction in chronic systemic diseases has become a popular and important health concern in recent years. This subject is quite new in the specialty of dermatology. We explore the relationships between dermatologic diseases and male sexual dysfunction.     

右耳廓假性囊肿一例

患者男,56岁,因右侧耳廓无明显诱因肿胀、痒5天,无其他不适,于2008年2月16日入院.患者诉5天前无明显诱因出现右耳廓肿胀、奇痒,耳廓变厚,逐渐加重.     

Management of external ear keloids using form-pressure therapy

Keloids are a frequent finding after physical trauma. Keloids of the pinna (helix and antihelix) as a complication of ear-piercing are the most difficult cases. Clinicians have tended to avoid the surgical approach, preferring local conservative treatment with corticosteroids or other treatments. We report use of intrakeloid resection and a form-pressure device to treat pinna keloids and avoid recurrence. The purpose is to maintain the form of the folds of the pinna. The recommendation for this therapy is to maintain the pressure at 24-30 mmHg, and the duration of the form-pressure therapy in our patients was about 25 weeks.     

Alveolar rhabdomyosarcoma on the external ear: a case report

Alveolar rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood. It typically has middle ear/temporal bone and nasopharynx as its most common head and neck sites. In fact, 'middle ear' is what is meant by 'ear' location in the many reports of pediatric RMS. This case report, however, is of RMS occurring on the external ear of a young female. RMS in skin should motivate a search for an occult extremity or visceral tumor, which was not present in this case.     

Micrographic surgery for the microscopically controlled excision of carcinoma of the external ear

Micrographic surgery is particularly valuable for treating carcinomas of the external ear because the total microscopic control of excision afforded by this method permits selective removal of the clinically unpredictable cancerous outgrowths. The maximum conservation of normal tissues, including the cartilaginous framework that gives shape to the ear, is a benefit next in importance to the unusually high 5-year cure rates (97.1% in a series of 1213 cases of basal cell carcinoma and 92.3% in a series of 871 cases of squamous cell carcinoma). The fresh-tissue technique for removing most auricular carcinomas usually permits the excision of the successive layers in 1 day, and repair, if needed, can be done immediately. The fixed-tissue technique is still used by the authors for some extensive, bone-invading carcinomas.