Intergluteal Fold Research Articles

Dermatologic Diagnoses in the Perianal Area

Perianal dermatosis can encompass lesions from benign eczematous processes to advanced malignancies. It is important for the colorectal surgeon to be able to distinguish common problems from more serious pathology. This article covers nonsexually transmitted diseases occurring in the intergluteal fold and perianal region. These include inflammatory dermatoses, bacterial and fungal infections, and other disease processes.

Large-volume lipoinjection for gluteal augmentation

Background: Although placement of silicone implants remains the standard technique for gluteal augmentation, lipoinjection of autologous fat obtained from lipoplasty is emerging as an alternative procedure. Objective: We report the results of large-volume lipoinjection of the gluteal region in a series of 96 patients. Methods: Lipoplasty was performed by using the wet-technique conventional method with previous infiltration of approximately 0.5 mL of solution for each mL of fat extracted. Autologous fat was injected through incisions from 5 to 8 mm long in the intergluteal fold and infragluteal groove of each side. Lipoinjection continued until the desired aesthetic contour was achieved or until the tension of the soft tissues became evident. Most patients received between 300 and 500 mL of autologous fat. Results: A durable increase of the gluteal regions was achieved in all patients; all but 2 patients were satisfied with the results. Complications included paresthesias, small irregularities or asymmetries that did not require special treatment or cause patient dissatisfaction, and 1 case of septic shock as a result of gluteal cellulitis. Conclusions: Large-volume lipoinjection is an alternative to silicone implants for augmentation of the gluteal area that can provide greater volume increase while eliminating the risk of implant rupture and the need for follow-up surgery. ( Aesthetic Surg J 2002;22:33-38.)

Modifications of Buttock Augmentation

The traditional method of buttock enlargement, which involves making an incision in the lower portion of the buttocks in the infragluteal fold, frequently results in secondary infections and long recovery times. Because of the proximity of the incision to the rectum and the pressure on the incision, the patient usually requires several days of bed rest. In some instances, it is necessary to remove an otherwise satisfactory implant to correct an infection. The author has overcome this problem by placing the incision in the center of the buttock in the intergluteal fold. A custom-designed solid silicon prosthesis is then placed between the gluteus medius and the gluteus maximus in a space provided by the anatomical design of these two large muscles. The gluteus also provides a good sling for the prosthesis, thus preventing future drooping of the prosthesis. More than 20 buttock enlargements have been successfully performed using this technique with no major complications. Use of this new technique decreases the risk of infection from the anal region and produces a softer, more natural look. This technique is also resistant to possible rupture such as may occur with a nonsolid gel silicone augmentation.

Skin ulceration as sole manifestation of Langerhans-cell histiocytosis

A 65-year-old black woman presented with skin ulceration of 5 years' duration which affected the left axilla, left groin, intergluteal folds and ano-perineal region. The diagnosis of Langerhans-cell histiocytosis (LCH) was confirmed by light and electron-microscopic findings and a positive S-100 stain. Extensive investigations failed to reveal any evidence of systemic involvement. A review of the literature suggests that this clinical picture as the sole manifestation of the disease is rare.

How I Manage Pilonidal Disease

In brief: Pilonidal disease is a typical foreign-body reaction. Free hair migrates into the intergluteal fold in the sacral coccygeal area and perforates the skin, which sets up a point of entry for further hair buildup. The hair ball causes no reaction or symptoms until it is invaded by pathogens. Abscess, draining sinuses, and cellulitis then develop. Treatment is an outpatient procedure and is essentially the same whether there is a cyst, sinus granuloma, or abscess. It may be necessary to infiltrate over the area and allow purulent sanguineous material to drain out before irrigating the area. A small foreign-body snare is used to extract the hair. Recurrences can be prevented by emphasizing the importance of shaving and local cleansing.

New approach to the problem of pilonidal sinus.

Abstract The insertion of hairs at the depth of the intergluteal fold causes pilonidal sinus, but current treatment assists the free entrance of new hairs by opening portals of entry at the depth. 1687 cases of pilonidal sinus have been treated by an operation which places resistant skin at the depth of the intergluteal fold, and follow-up suggests a low recurrence-rate.

Use of the buttock to reconstruct the breast

An easy, accurate surgical procedure for the reconstruction of the breast is presented using the buttock as donor tissue. The shape of the resulting breast is good and the donor scar remains mostly hidden in the intergluteal fold.

CONGENITAL ABSENCE OF THE SACRUM AND COCCYX

The patient here reported presented multiple skeletal abnormalities indicating diffuse adverse influences brought to bear principally on the developing spinal column. The absence of two ribs on one side coincided with the absent halves of the thoracic vertebrae, thus indicating the intimacy of the primordium of a rib and its corresponding vertebra2. The clinical appearance of tapered lower extremities, as well as the unilateral clubfoot and rectal and urinary incontinence, coincided with the experience recorded in previous papers. The narrowed pelvis, flattened buttocks, and shortened intergluteal fold were natural sequelae of total absence of the saerum. Despite the extensive skeletal changes, this child was able to sit and walk, although walking was materially compromised by the rigid deformity of the left foot. At present, suitable conservative orthopaedic measures are again being directed toward correcting the recurrent and difficult foot deformity.

INTERTRIGO (CHAFING) TREATED WITH TANNIC ACID AND BRILLIANT GREEN

Literature on intertrigo, a distressingly common disease, is exceedingly scarce, particularly in the United States. Therefore, in order to make clear the logic of the proposed therapy, I shall briefly review its known causes and symptoms. Intertrigo results from friction of apposing surfaces of the skin and occurs in the following locations: the groins, the intergluteal folds, the inner sides of the thighs, the axillas, the submammary folds of women, the hypogastric fold, the retroauricular fold and the folds of the neck, groins and buttocks of newborn infants. Additional etiologic factors are obesity, excessive perspiration, heat, fungous or bacterial infection and regional secretions such as urine, feces, serous or purulent discharges, vaginal discharges and menstrual fluid. The condition may manifest itself on the skin as a mild erythema, a vesicular or papular eruption similar to that of lichen tropicus (prickly heat) or as a vesicular, papular, or lichenified eczema which

BROWN-SÉQUARD SYNDROME AS A MANIFESTATION OF SYPHILITIC NEURORECURRENCE

Although syphilis, according to Oppenheim 1 and others, is not infrequently responsible for the causation of the Brown-Sequard syndrome, we have been able to find no instance on record in which the syndrome has been the manifestation of syphilitic neurorecurrence involving the spinal meninges—that is to say, the manifestation of an acute syphilitic meningitis following the lapse of treatment with arsphenamine in a case of early syphilis which originally had no clinical or serologic signs of involvement of the central nervous system. In view of this fact, the following case is reported. REPORT OF CASE Clinical History. —A Chinese soldier, aged 39, presented himself at the Peiping Union Medical College Hospital, on Sept. 22, 1928, complaining of a genital sore of more than two months' duration. Examination at that time revealed a solitary, deep, nontender and indurated lesion about 1.5 cm. in diameter in the coronary sulcus. In the intergluteal fold