1. Reflectance Confocal Microscopy (RCM) generates images comparable to histology. Past clinical trials on NMSC using RCM have shown promising results 2 3 4 , but the role of RCM needs better definition. Objectives We aimed to compare RCM to excision biopsy histology in NMSC management in an Australian population to evaluate its diagnostic use.Materials and methodsPatients referred with difficult-to-diagnose skin lesions before excision were included. RCM images of each lesion were obtained prior to surgical intervention and were compared with the post-operative histological findings. Results A total of 137 patients were

The modern colorful permanent tattoos are usually performed by professional tattooist. Solid pigment/ink particles injected through the epidermis into deep dermis can cause multiple adverse reactions.We report the case of 46 years old women that was admitted to the plastic surgery outpatient clinic with ulcerative skin lesions on her right ankle's tattoo. According to her history, 2.5 years previously dual color tattoo (black bracelet with three red hearts in it) was performed in a professional tattoo clinic. On physical examination, the patient had a circular black tattoo pattern with 3 heart shape ulcerated skin lesions interposed in the tattoo on her ankle. Under local anesthesia the largest, central lesion was excised. Histology examination of the skin specimen revealed combined lichen planus reaction in the center of the lesion and peripheral granulomatous sarcoid type reaction. CASE REPORT We report a case of combined lechenoid and granuloumatous reaction developed in the red part of the 2.5 years old tattoo on the patient's right ankle. A 46-year-old woman admitted to plastic surgery outpatient clinic due to slow growing lesions on her right ankle tattoo. According to her history 2.5 years ago dual colored tattoo bracelet (black circumferential pattern with three red interposed hearts) was performed in a professional tattoo clinic. The lesions had been growing for 7 months. The dye used for the tattoo was “Millennium colorworks inc. Monthly red”. The main ingredients of the red pigment according to manufacturer annotation was CI#12475 (4-[[4(aminocarbonyl) phenyl]azo]-N-(2-ethoxyphenyl)-3hydroxy2-Naphthalene Carboxamide) combined with glycerin, water and alcohol. There were no signs of local inflammation of the surrounding skin or regional lymph node involvement. The patient is a heavy smoker, suffers from epilepsy, currently treated with Topiramate and Phenytoin. She does not have any known allergies. She has another two tattoos on her chest and abdomen (blue shark). She had an episode of deep vein thrombosis and pulmonary embolism in the past. The lesions on her ankles were previously treated by a dermatologist with local antihistamines and steroids injections for few months without any improvement. The local findings on her ankle were a black tattooed bracelet with 3 heart shaped, ulcerated skin lesions on red background of the tattoo, resembling Squamous cell carcinoma (figure 1). The biggest lesion measured 15 x 10 mm, restricted exclusively to the red part of the tattoo and was excised under local anesthesia by plastic surgeon preserving the main design of the tattoo. The wound had healed well with normal linear scar. Histological examination (hematoxylin eosin staining) revealed inflammatory response of the tattooed skin resembling hypertrophic lichen planus reaction in the center of the lesion and peripheral granulomatous reaction (sarcoid type). Lichenoid Reaction To Colored Professional Tattoo Of Skin. 2 of 3 Figure 1 Figure 1+2. Skin lesion resembling SCC on the red part of tattoo.

The portrayal of the human form can be traced to approximately thirty thousand years. While the aesthetic criteria developed for the human face tend to emphasize secondary sexual characteristics and average ness; the depiction of the body reflects the innate need to exaggerate culturally desirable features at the expense of realism. Newer anthropometrical measurements of the human face challenge previously accepted canons of the classical period.

Major complicated injuries of the upper limb that once led to amputation are now being successfully salvaged. The goals of treatment in such cases are rigid fixation of fractures, reliable stable coverage of important structures, preservation of function and an acceptable cosmetic result. There is no consensus in the literature regarding the treatment strategy of upper limb trauma with damage distal to the olecranon. The latissimus dorsi musulocutaneous flap is often used for upper limb reconstruction for functional elbow restoration following different sorts of injures [1-5].We report two cases of major trauma of the elbow and forearm distal to the olecranon, that have been successfully treated by skeletonized, pedicled, denervated latissimus dorsi musculo-cutaneous flaps.

Background: We describe here a very rare presentation of Post Burn Contracture axilla in which an underlying infected epidermal inclusion cyst was mimicking Marjolin’s ulcer in its presentation.Material and Methods: The patient with Post Burn contracture axilla was treated with release and split skin grafting after excision of the epidermal inclusion cyst.Results: Axilla was released and grafted. Patient was kept on strict splintage and physiotherapy programme to encourage movements. The patient is on regular follow-up and further monitored physiotherapy has been planned to provide a better functional and aesthetic limb.Conclusion: The presentation of Post Burn Contracture axilla described here has not been mentioned in world literature so far and its presentation is a matter of discussion. Opinions regarding possibilities of such presentation are invited from experts in the field.