br Discussion We reported the success and satisfactory resul

Discussion We reported the success and satisfactory results of SIH in a series of patients with basal cell carcinoma of the face after excision. In the current era of elegant and elaborate reconstructive techniques, SIH is often underutilized. However, under certain circumstances, SIH can offer functional and cosmetic outcomes that equal or are superior to those achieved by primary closure, grafts, and flaps. This simple reconstructive method allows optimal wound bed surveillance for tumor recurrence with a low complication rate, and the avoidance of complex procedures in patients who are at risk of long operation time. However, SIH in anatomic areas with high contractile forces, such as eyelid margins and eyebrow and lip vermilion borders, may result in retraction of free tissue margins. Thus, this technique is not recommended in these anatomic areas. Disadvantages of SIH include prolonged healing time, the need for daily wound care, and occasionally unpredictable cosmetic results. The cosmetic outcome can only be assessed after complete wound healing. There are some factors to consider when choosing patients for SIH. Location is probably the most important predictive factor for the esthetic outcome SIH. Wound contraction is usually more favorable in concave areas. The extent of wound contraction depends on the initial wound size and is positively correlated with the degree of surface concavity, adjacent Digoxigenin-11-ddUTP laxity, and the action of underlying skeletal muscles. The favorable outcome in our patients may relate to relatively small tumor sizes in our series (average, 1 cm). A small wound (<1 cm) can heal more than 70% by wound contracture with acceptable cosmetic outcome in comparison with a larger wound (>2.5 cm in diameter). A superficial defect, even on a convex surface, may also heal with acceptable cosmesis as illustrated by the wound on the forehead in patient 3 (Figure 2C). Aged skin (in patients with mean age 73 years) may be another factor attributed to a more favorable outcome in our patients. Skin in elderly patients is more relaxed and the presence of irregular contour and pigment can readily camouflage operation scars. Indeed, several authors suggested that elderly patients are better candidates for SIH. The traditional wound dressing for an incisional wound contains three layers – a nonadhering layer in contact with the wound, an absorptive layer that absorbs wound exudates, and a binding layer to fix the dressing in place. However, the dressings may be too bulky and cumbersome for patients and the relatively dry environment is not optimal for wound healing. An occlusive or semiocclusive dressing that provides a moist healing environment is believed to facilitate wound healing by accelerating reepithelialization and minimizing desiccation, necrosis, and pain. For our patients, the goal was a simple wound dressing that could be done by the patient at home. We educated the patients on how to clean the wound with normal saline and cover with gauze after filling the wound with antibiotic ointment. The ointment provides a semiocclusive environment for the wound. Indeed, all wounds healed without complications within 4 weeks.
Introduction Mycosis fungoides (MF) comprises about 65% of cutaneous T-cell lymphomas. It generally presents with an indolent course and a long evolution, with years to decades elapsing before patches or plaques progress to tumor stage. Large cell transformation (LCT) in MF has been defined by the presence of large cells (at least four times larger than a small lymphocyte) exceeding 25% of the total lymphoid infiltrate or forming microscopic nodules. LCT is often found in advanced-stage disease (≥Stage IIB) and is very rare in the early stage (≤Stage IIA). LCT in MF is associated with an aggressive course and poor prognosis. Large transformed cells may be positive for CD30 or not. Herein, we reported a patient with Stage IB MF, who also showed focal CD30-positive LCT.