摘要:

Summary:Necrotizing fasciitis is a rare infection of the deep and subcutaneous tissue layers most commonly caused by group A β-hemolyticStreptococcus.The disease begins as a typical cellulitis. Necrosis of the deeper tissues progresses rapidly, accompanied by a dusky, gray-blue skin discoloration with erythematous margins. Even with appropriate treatment, mortality rates remain as high as 36%. Most cases of necrotizing fasciitis have been reported in the general surgical literature, associated with trauma or as a postoperative wound infection after abdominal and gynecologic procedures. Of the 50 cases involving the eyelids reported in the literature, only three were reported to have occurred as a “postoperative” complication. This report is of the first known case of streptococcal necrotizing fasciitis complicating a conjunctival dacryocystorhinostomy.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Most choroidal melanomas are diagnosed when the tumor is still relatively small and confined to the globe. Rarely, these tumors can escape detection and extend through the sclera. They can reach a large size and create significant orbital inflammation. The authors describe a 71-year-old man with orbital cellulitis secondary to a necrotic choroidal melanoma that invaded the orbit. This tumor had minimal intraocular involvement with a large extrascleral component. On histopathologic analysis, the lesion was best classified as a spindle B melanoma with epithelioid areas (mixed melanoma). The patient was treated with an enucleation and postoperative radiation. This report demonstrates that malignancies in the orbit can present as acute infections. Early suspicion, diagnosis, and treatment of these lesions offer the best chance for survival.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Pseudomonal eyelid necrosis is a rare condition that has not been well characterized. Five case reports have been previously described. The authors present an additional case, describe its unique features, review the previous reports, and establish the clinical characteristics of the disorder. Pseudomonal eyelid necrosis always occurs in the setting of neutropenia. It may be unilateral or bilateral, and is managed with wound debridement, intravenous and local antibiotics, and, most important, restoration of the neutrophil count. A delay in diagnosis and treatment may lead to functional impairment and cosmetic disfigurement. Although not previously reported in association with eyelid necrosis, uncorrected neutropenia in association with pseudomonal soft tissue infection elsewhere in the body has been associated with septicemia and death. Familiarization with the salient features of the disorder allows prompt therapeutic intervention and may prevent potentially serious complications.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Ophthalmic manifestations are a common component of the ectrodactyly-ectodermal dysplasia-clefting (EEC) syndrome; however, few ophthalmic publications have specifically addressed these features. The authors describe a 38-year-old patient with EEC syndrome who demonstrated several associated ocular signs and symptoms. The ophthalmic findings in this patient included bilateral entropion with secondary trichiasis, and shallow inferior fornices with symblepharon. Interestingly, the patient also had vertically deficient tarsi and absence of the meibomian glands. Ophthalmologists should be aware of the ocular signs and symptoms associated with EEC because some manifestations can potentially be sight threatening.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

Summary:Repair of soft tissue loss of the medial canthal area is usually accomplished by using skin grafts or frontal flaps based on the glabellar vessels. However, skin grafts can provoke scar tissue contracture, or skin color chromatic changes (hypopigmentation or hyperpigmentation). On the other hand, frontal flaps are sometimes thicker than normal skin and lead to unsatisfactory aesthetic results. To avoid these disadvantages, the authors designed an alternative method for reconstruction of defects of the medial canthal area. The authors suggest using a myocutaneous flap (V-Y design) from the nasal bridge to repair soft tissue defects no larger than 2 cm in diameter (surface <4 cm2) in the medial canthal area. The pedicle of this flap is based on supratrochlear and dorsal nasal vessels. This technique has proved safe and reliable and has led to good functional and cosmetic results.

ISSN:0740-9303    

出版商:OVID    

年代:1998

数据来源: OVID