Skin Of Lower Extremities Research Articles

Severe Avulsion Injury of the Lower Extremity Skin

In a case of severe skin avulsion of the lower extremity associated with open injuries of the knee and ankle joint, treatment combining several modes of therapy resulted in a cosmetically acceptable and useful limb. This was achieved operatively by thorough wound cleansing, defatting of the avulsed skin, and circumferential grafting to reappose the sagging musculature. Postoperative care included the use of continuous skeletal wire elevation, continuous irrigation and suction of the joints, and intermittent hyperbaric oxygen therapy.

Severe avulsion injury of the lower extremity skin

Severe avulsion injury of the lower extremity skin

Lower extremity skin coverage in children.

In the child with an extensive burn, a more complete coalescence of postage stamp grafts, with sturdier epithelium, takes place, and new superficial venous channels spring up in a relatively short time. When tendon exposure occurs there will often develop a granulation tissue covering from the surrounding areas within 10 to 14 days. This is less time than it would take to prepare an abdominal-pedicle or a cross-leg flap. Long-standing immobilization of a joint of a child or exposure of the joint of a child are not the major problems that they are in the adult. Comparison between the adult and the child, from the problem of the simple small superficial coverage to that of the larger deep areas, can be made in practically every circumstance.

Studies in Experimental Systemic Mycosis

The term chromoblastomycosis, as originally used by Terra and coworkers (1) to designate a fungus disease, was revised by Moore and de Almeida (2) to chromomycosis. The disease does not correspond to a true blastomycosis since the fungus divides, both in culture and in tissue, by cross wall or septum formation and not by budding. The newer term eliminates the possibility of confusion. Numerous cases of chromomycosis have been reported throughout the world. The majority were caused by the fungus Hormodendrum pedrosoi, a few by the closely related Phialophora verrucosa. The disease is rarely diagnosed clinically except in endemic areas, where its manifestations are generally considered to be largely limited to the skin of the lower extremities, especially of the feet and shanks. Lesions have, however, been described on the hand, ear, face, shoulder, arm, neck, buttocks, and thigh. It is the consensus that these are due to direct inoculation of the fungus into an area of local injury.

NODULAR MYXEDEMA COMPLICATING THYROTOXICOSIS

Since Kocher's 1 early report of the occurrence of isolated areas of myxedematous change in the skin of the lower part of the leg in certain cases of thyrotoxicosis, there have appeared about ten reports concerning this syndrome, covering 22 cases. The areas appear as nonpitting elevated plaques of the skin of the lower extremity of thyrotoxic patients, and occur most frequently after thyroidectomy. The most extensive group of cases reported to date is that of O'Leary, 2 who reported 8. In 7 of these the plaques appeared after the onset of thyrotoxicosis, but in the other case the cutaneous changes preceded it. Netherton and Mulvery 3 reported 3 cases in which tibial plaques appeared five years after thyroidectomy. The plaques varied from smooth elevated nonpitting areas resembling pigskin to those having the nodular irregular surface described in the case reported here. Because of the appearance of plaques in a