A man with unilateral endophthalmitis: a case of disseminated nocardiosis.

We present the case of a patient with an infection by Nocardia which manifested itself with monocular endophthalmitis. Nocardia infection is not common and ocular involvement is one of the most uncommon presentations. In these cases it is very important to make an early diagnosis and intensive treatment to prevent the visual prognosis.

Assessment of quality of life of patients under phototherapy for dermatological diseases

The skin and appendages is one of the first things in which people repair their social relationships as an alteration of these can influence the image and in multiple aspects of the subject’s life. Psoriasis is a chronic, relapsing skin disease that produces a marked reduction in the quality of life. Phototherapy, especially in form of narrow-band UVB is an alternative treatment of choice in plaque psoriasis and psoriasis of moderate extent. Also, regarding the impact of such treatment on quality of life of patients with psoriasis, there are few studies analyzing this effect.

Presentación caso clinico:ptiriasis vesicolor

One presents a clinical case, of a man of approximately 40 years, presenting like clinical stains of variable coloration, of brown aspect and hipocrómicas, that on having been scraped flake off easily. After his diagnosis of ptiriasis vesicolor, it yields to antifúngicos topics. We will analyze this one I marry, and we will see his etiology, clinic dignóstico and treatment.

Free flaps in surgical dermatology. Comparison between fasciocutaneous and myocutaneous free flaps in facial reconstructions.

BACKGROUND Dermatologic surgeons routinely harvest pedicled flaps at distance with an axial or random pattern to repair facial defects. These types of skin flaps are time-consuming and have high economic, social and personal costs. These drawbacks could be avoided with the introduction of a single-step transfer of free flaps to the recipient site, with microvascular anastomosis. OBJECTIVE To demonstrate that better results are obtained with myocutaneous or fasciocutaneous free flaps and which one is more suitable in surgical dermatology. MATERIAL AND METHODS We selected two patients of opposite sexes and similar ages who had undergone Mohs surgery to remove recurrent malignant tumors that were located in the upper cheek bordering the zygomatic zone. The woman was treated with a fasciocutaneous radial free flap and the man with a rectus abdominis free flap. RESULTS Both patients had excellent immediate postoperative outcomes. Complications observed in the male patient were related to a previous pulmonary alteration. The fasciocutaneous radial free flap reconstruction was easier to perform than the rectus abdominis free flap; nevertheless, the radial free flap is very thin and, although the palmaris longus tendon is used, it does not yield enough volume, requiring later use of implants. In contrast, the rectus abdominis free flap transfers a wide flap with enough fat tissue to expand in the future. As for the cosmetic results regarding the donor site, the rectus abdominis free flap produces better-looking scars, since secondary defects of the palmar surface cannot be directly closed and usually require grafting - a situation that some patients do not accept. CONCLUSIONS In surgical dermatology, each case, once the tumor has been extirpated, requires its own reconstructive technique. The radial free flap is suitable for thin patients who are willing to cover their arm with a shirt. The rectus abdominis free flap is best suited for obese patients with deep and voluminous defects, although it is necessary to dislocate the navel from its original position.

Keratotic Nodule on The Heel: A Quiz.

A 51-year-old man, with a medical history of medullary thyroid carcinoma excised under thyroxine treatment presented with a painful enlarging lesion on his right heel since one year. A 3-cm diameter, greyish, infiltrated nodule with spicules was seen on physical examination (Fig. 1a). A 5-mm surgical excision was made and a total skin graft was used for reconstruction. Histopathology of the total resected tumour revealed pseudoepitheliomatous hyperplasic epidermis and a proliferation located between rete ridges, dermis and superficial hypodermis (Fig. 1b). The proliferation was composed of nets and cordons of cells with granular and abundant PAS-positive cytoplasm. Immunostains showed cytoplasmic positivity for s100 and inhibin (Fig. 1c). Three years later the patient is asymptomatic.