 | Your DermAtlas query returned 4 ImagesClick on the IMAGE to see an enlargement. |
 © 2001-2009, DermAtlas | Image Name: | comedones_1_060109 | File Type: | jpg | |
| Diagnosis: | COMEDONES, OPEN / CYST | Category: | acneiform / surgery, Mohs | ||
| Body Site: | cheek | Age: | 41 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | Histologic sections of skin show several small dilated keratin-filled cysts. The central one connects to the overlying epidermis in this plane. The cyst lining consists of bland, stratified squamous epithelium. Near the orifice, there is a suggestion of follicular origin. | ||||
| Comments: | Although it is unusual to biopsy comedones, these were present in a 41-year-old woman who recently had Mohs surgery for a basal cell carcinoma. The differential diagnosis would include other benign cysts, such as large milial cysts, but clinically these were open comedones biopsied to rule out recurrent carcinoma. | ||||
 © 2001-2009, DermAtlas | Image Name: | bilobed_flap_1_051228 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL / FLAP, BILOBED | Category: | neoplasm, malignant / treatment / surgery, Mohs | ||
| Body Site: | nose | Age: | 68 years | ||
| Contributor: | Adam Mamalek | ||||
| Description: | outline of the tumor | ||||
| Comments: | This 68-year-old Caucasian man was referred for Mohs surgery of a basal cell carcinomma on the nose. The resultant defect was repaired with a bilobed flap. The bilobed flap is a double transposition flap that affords a practical means of repairing nasal surface defects smaller than 1.5 cm in diameter. Initially described with an arc of rotation of 180 degrees, the Zitelli modification confines the total arc of rotation to 90 to 110 degrees. The diameter of the first lobe is designed equal to that of the defect. The diameter of the second lobe is decreased to aid in donor site closure. Wide undermining in the submuscular plane is necessary to mobilize the flap. Each lobe should not rotate more than 50 degrees. Lateral based flaps are performed to fill defects on the nasal tip, and medial based flaps are employed for defects on the ala. Efforts to allign the resultant scar lines at the borders of the nasal subunits will result in superior cosmetic outcomes. | ||||
| Related Images: | All related Images bilobed_flap_3_051228 bilobed_flap_2_051228 | ||||
 © 2001-2009, DermAtlas | Image Name: | bilobed_flap_2_051228 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL / FLAP, BILOBED | Category: | neoplasm, malignant / treatment / surgery, Mohs | ||
| Body Site: | nose | Age: | 68 years | ||
| Contributor: | Adam Mamalek | ||||
| Description: | tumor excised and bilobed flap outlined | ||||
| Comments: | This 68-year-old Caucasian man was referred for Mohs surgery of a basal cell carcinomma on the nose. The resultant defect was repaired with a bilobed flap. The bilobed flap is a double transposition flap that affords a practical means of repairing nasal surface defects smaller than 1.5 cm in diameter. Initially described with an arc of rotation of 180 degrees, the Zitelli modification confines the total arc of rotation to 90 to 110 degrees. The diameter of the first lobe is designed equal to that of the defect. The diameter of the second lobe is decreased to aid in donor site closure. Wide undermining in the submuscular plane is necessary to mobilize the flap. Each lobe should not rotate more than 50 degrees. Lateral based flaps are performed to fill defects on the nasal tip, and medial based flaps are employed for defects on the ala. Efforts to allign the resultant scar lines at the borders of the nasal subunits will result in superior cosmetic outcomes. | ||||
| Related Images: | All related Images bilobed_flap_3_051228 bilobed_flap_1_051228 | ||||
 © 2001-2009, DermAtlas | Image Name: | bilobed_flap_3_051228 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL / FLAP, BILOBED | Category: | neoplasm, malignant / treatment / surgery, Mohs | ||
| Body Site: | nose | Age: | 68 years | ||
| Contributor: | Adam Mamalek | ||||
| Description: | flap in place | ||||
| Comments: | This 68-year-old Caucasian man was referred for Mohs surgery of a basal cell carcinomma on the nose. The resultant defect was repaired with a bilobed flap. The bilobed flap is a double transposition flap that affords a practical means of repairing nasal surface defects smaller than 1.5 cm in diameter. Initially described with an arc of rotation of 180 degrees, the Zitelli modification confines the total arc of rotation to 90 to 110 degrees. The diameter of the first lobe is designed equal to that of the defect. The diameter of the second lobe is decreased to aid in donor site closure. Wide undermining in the submuscular plane is necessary to mobilize the flap. Each lobe should not rotate more than 50 degrees. Lateral based flaps are performed to fill defects on the nasal tip, and medial based flaps are employed for defects on the ala. Efforts to allign the resultant scar lines at the borders of the nasal subunits will result in superior cosmetic outcomes. | ||||
| Related Images: | All related Images bilobed_flap_2_051228 bilobed_flap_1_051228 | ||||
    Books by the Dermatlas Editors | © DermAtlas, Johns Hopkins University; 2000-2009 |
Link directly to this page: http://DermAtlas.med.jhmi.edu/derm/result.cfm?Category=-569810211