Dermatosurgery

1. Surgical Indications in Dermatology.- 1.001 Tumors, Preblastomatoses, Cysts, and Malformations.- 1.002 Benign Epithelial Tumors.- 1.003 Basal Cell Papilloma. Verruca Seborrheica 3 / 1.004 Verruca Vulgaris 4 / 1.005 Condyloma Acuminatum 5 / 1.006 Molluscum Contagiosum 5 / 1.007 Verrucous Epidermal Nevus and Rare Epidermal Nevi 5 / 1.008 Nevus Sebaceous (Jadassohn) 5 / 1.009 Clear Cell Acanthoma (Degos) 5 / 1.010 Rare Benign Tumors of the Skin Glands 6 / 1.011 Sebaceous Gland Adenoma 6 / 1.012 Senile Sebaceous Gland Hyperplasia 6 / 1.013 Rhinophyma 6 / 1.014 Nevus Comedonicus 6 / 1.015 Trichofolliculoma 6 / 1.016 Malherbe's Epithelioma 6.- 1.017 Cysts.- 1.018 Follicle Retention Cysts 7 / 1.019 Traumatic Epidermal Cysts 7 / 1.020 Milia 7.- 1.021 Precanceroses.- 1.022 Keratoma Solare 7 / 1.023 "Cornu Cutaneum." Compare Molluscum Contagiosum (Sect. 1.006) 8 / 1.024 Tar and Oil Keratoses 8 / 1.025 Arsenic Keratosis 8 / 1.026 Bowen's Disease 8 / 1.027 Erythroplasia of Queyrat 9 / 1.028 Leukoplakia 9 / 1.029 Cheilitis Abrasiva Precancerosa (Manganotti) 9 / 1.030 Radiodermatitis, Roentgenism 9 / 1.031 Lichen Sclerosus et Atrophicans 9 / 1.032 Intraepidermal Epithelioma (Borst-Jadossohn) 10.- 1.033 Carcinomas.- 1.034 Squamous Cell Carcinoma 10 / 1.035 Carcinomas of the Skin Appendages 10 / 1.036 Paget Carcinoma 10 / 1.037 Skin Metastases of Internal Carcinomas 11.- 1.038 Pseudocancerous Lesions.- 1.039 Keratoacanthoma 11 / 1.040 Papillomatosis Cutis Carcinoides Gottron 11 / 1.041 Pseudocarcinomous Hyperplasia 11 / 1.042 Oral Florid Papillomatosis 11.- 1.043 Basal Cell Carcinoma and Related Tumors.- 1.044 Basal Cell Carcinoma 12 / 1.045 Premalignant Fibroepithelial Tumor (Pinkus) 13 / 1.046 Spiegler's Tumor 13 / 1.047 Epithelioma Adenoids Cysticum (Brooke) 13 / 1.048 Nevoid Basal Cell Carcinomas 13 / 1.049 Basal Cell Nevus Syndrome (Fifth Phacomatosis) 13.- 1.050 Benign Tumors of the Pigment-Producing Cells.- 1.051 Lentigo 14 / 1.052 Lentigo Senilis 14 / 1.053 Nevus Pigmentosus 14 / 1.054 Juvenile Melanoma (Spitz) 15 / 1.055 Nevus Coeruleus 15 / 1.056 Nevus Pilosus 15 / 1.057 Melanophacomatosis (Virchow-Rokitansky-Touraine) 15.- 1.058 Premalignant and Malignant Neogenesis of the Pigment-Producing Cells (Steigleder and Clark et al. [54, 466]).- 1.059 Lentigo Maligna, Premalignant Melanosis Dubreuilh 15 / 1.060 Lentigo Maligna Melanoma, Dubreuilh Melanoma 16 / 1.061 Superficial Spreading Melanoma 16 / 1.062 Nodular Malignant Melanoma 16.- 1.063 Benign Tumors and Pseudotumors of the Connective Tissues.- 1.064 Histiocytoma, Dermatofibroma 17 / 1.065 Nevoxanthoendothelioma 18 / 1.066 Xanthelasmas 18 / 1.067 Xantomas 18 / 1.068 Keloid 18 / 1.069 Hypertrophic Scars 19 / 1.070 Pseudosarcomatous Fasciitis 19 / 1.071 Desmoid Tumor 19 / 1.072 Nontumorous Fibroplasia (see Sect. 1.117) 19 / 1.073 Adenoma Sebaceum in Conjunction with Phacomatosis (Bourneville-Pringle) 19.- 1.074 Semimalignant and Malignant Tumors of the Connective Tissue.- 1.075 Dermatofibrosarcoma Protuberans 19 / 1.076 Fibrosarcoma 19 / 1.077 Other Sarcomatous Forms 20.- 1.078 Tumors of the Fatty Tissue.- 1.079 Lipoma 20 / 1.080 Lipomatosis Dolorosa 20.- 1.081 Benign Lymphoplasias of the Skin.- 1.082 Lymphocytoma Cutis.- 1.083 Malignant Lymphomas and Hemoblastoses.- 1.084 Benign Tumors of the Vascular and Smooth Muscle Systems.- 1.085 Eruptive Angioma 20 / 1.086 Angioma Senile 21 / 1.087 Nevus Araneus 21 / 1.088 Angiokeratoma. (Preferable [231]: thrombosed angioma) 21 / 1.089 Angiokeratoma Akroasphyticum Mibelli 21 / 1.090 Angiokeratoma Inpunctiforme Scroti s. Vulvae Fordyce 21 / 1.091 Fabry's Disease 21 / 1.092 Capillary Hemangioma 21 / 1.093 Cavernous Hemangioma 22 / 1.094 Glomus Tumor 22 / 1.095 Multiple Familial Glomus Tumors 22 / 1.096 Leiomyoma, Angioleiomyoma 22 / 1.097 Granular Cell Myoblastoma 22 / 1.098 Lymphangiomas 22.- 1.099 Vascular Nevi.- 1.100 Nevus Teleangiectaticus Lateralis 23 / 1.101 Nevus Flammeus Medialis Unna 23.- 1.102 Semimalignant and Malignant Vascular Tumors.- 1.103 Hemangiopericytoma 23 / 1.104 Hemangioendothelioma 23 / 1.105 Kaposi's Sarcoma 23 / 1.106 Hemangiosarcoma 23.- 1.107 Tumors of the Nerves and Nerve Sheaths.- 1.108 Neurilemmona, Neurofibroma 24 / 1.109 Recklinghausen's Neurofibrosis 24 / 1.110 Neurofibrosarcoma 24.- 1.111 Dysplasias, Hyperplasias, and Fibroses.- 1.112 Tylositas Articuli 24 / 1.113 Palmoplantar Fibrosis (Dupuytren's Contracture) 24 / 1.114 Juvenile Palmoplantar Fibrosis 24 / 1.115 Induratio Penis Plastica 24 / 1.116 Pseudoxanthoma Elasticum 24 / 1.117 Cutis Laxa and Cutis Hyperelastica 24.- 1.118 Inflammatory and Functional Skin Lesions.- 1.119 Inflammations Originating from Hair Follicles and Sebaceous Glands.- 1.120 Deep Necrotizing Perifolliculitis 25 / 1.121 Dissecting Cellulitis of the Scalp, Periofolliculitis Capitis Abscedens et Suffodiens 25 / 1.122 Dermatitis Perianalis Fistulosa 25 / 1.123 Pyodermia Fistulans Sinifica 25 / 1.124 Acne Conglobata, Acne Abscedens 25.- 1.125 Inflammations Originating in the Sweat Glands, the Odoriferous Glands, and the Mucous Membranes.- 1.126 Hidradenitis Suppurativa 26 / 1.127 Bartholinitis 26.- 1.128 Chronic Inflammations Originating around the Vessels.- 1.129 Tuberculosis Cutis Luposa 26 / 1.130 Sarcoidosis (Besnier-Boeck-Schaumann) 27 / 1.131 Cheilitis Granulomatosa (see Sect. 3.044) 27 / 1.132 Deep Mycoses and Diseases Due to Actinomyces 27 / 1.133 Leishmaniasis 27.- 1.134 Inflammations that Spread to the Skin.- 1.135 Dental Skin Fistulas 27 / 1.136 Tuberculosis Cutis Colliquativa 27.- 1.137 Cicatricial Post-inflammatory States and Post-thrombotic Syndrome.- 1.138 Phimosis 27 / 1.139 Superficial Thrombophlebitis 28 / 1.140 Varicosis in Chronic Venous Insufficiency 28 / 1.141 Small Varicose Dilations of Cutaneous Veins 28 / 1.142 Pachydermia Vegetans and Papillomatosis Cutis 29 / 1.143 Dermatopathy of the Leg 29 / 1.144 Elephantiasis Nostras 29 / 1.145 Leg Ulcer 29 / 1.146 Arteriosclerotic and Diabetic Gangrene of the Leg 30.- 1.147 Lesions Due to Foreign Bodies and Trauma.- 1.148 Foreign Body Granuloma 30 / 1.149 Tattoos and Other Corial Foreign Body Intrusions 30 / 1.150 Keloid (cf. Sect. 1.068) 30 / 1.151 Traumatic Epithelial Cysts (cf. Sect. 1.019) 30 / 1.152 Chondrodermatitis Nodularis Chronica Helicis Winkler 30 / 1.153 Callosities, Tyloma 30 / 1.154 Burns and Scalding 30 / 1.155 Chemical Burns 31 / 1.156 Wounds 31 / 1.157 Suture Dehiscence 31.- 1.158 Functional and Cosmetic Disorders.- 1.159 Axillary Hyperhidrosis 31 / 1.160 Cosmetic Surgery 32.- 1.161 Lesions of the Nails.- 1.162 Onychomycoses 32 / 1.163 Ingrown Toenail 32.- 2. Basic Principles of Dermatosurgery: Survey of Surgical Techniques.- 2.001 Requirements and Considerations.- 2.002 Surgical Instruments.- 2.003 Pre- and Postoperative Care.- 2.004 Anesthesia Procedures.- 2.005 Local Anesthesia (for techniques, cf. [11, 330]) 39 / 2.006 Local Anesthetics 39 / 2.007 Marginal Wall Anesthesia 39 / 2.008 Conduction Anesthesia 39 / 2.009 Special Regional Anesthesia Procedures 40 / 2.010 General Anesthesia 40.- 2.011 Incisions and Suture Techniques.- 2.012 Interrupted Sutures 41 / 2.013 Mattress Sutures 41 / 2.014 Continuous Intradermic Suture 41 / 2.015 Removal of Sutures 42.- 2.016 Surgical Techniques.- 2.017 Skin Biopsy 42 / 2.018 Elliptical Excision with Primary Wound Closure 42 / 2.019 "Dehnungsplastik" (Friederich [19] 43.- 2.020 Regional Flaps.- 2.021 Z-Flap Technique 4 / 2.022 VY-Flap Technique 44 / 2.023 Advancement Flap Technique 44 / 2.024 Rotation Flap Technique 45 / 2.025 Transposition Flap Technique 45 / 2.026 Island Flap Technique 45 / 2.027 Combination of Techniques 46.- 2.028 Flaps and Grafts from Other Body Areas.- 2.029 Free Skin Grafts 46 / 2.030 Tubed Pedicled Flaps 47.- 2.031 Dermabrasion.- 2.032 Electrosurgery.- 2.033 Electrotomy 48 / 2.034 Coagulation 48 / 2.035 Desiccation 48 / 2.036 Fulguration 48 / 2.037 Curettage 49.- 2.038 Chemosurgery.- 3. Special Techniques for Different Regions of the Body.- 3.001 Scalp.- 3.002 Rotation Flap Technique.- 3.003 Double Rotation Flap Technique 51 / 3.004 Rotation Flap Technique Combined with Free Skin Graft 51 / 3.005 Full-Thickness Skin Graft 52 / 3.006 Transplantation of Multiple Punch Biopsies 52 / 3.007 Surgery for Relaxation of the Scalp 52.- 3.008 Temporal Region.- 3.009 Caudal Advancement Flap Technique 53 / 3.010 Advancement Flap Technique-Free Skin Grafting Combination 54 / 3.011 Dorsal Rotation Flap Technique 54 / 3.012 Caudal Rotation Flap Technique 54 / 3.013 Free Skin Grafting Technique (Split-thickness Skin Grafts) 55.- 3.014 Forehead.- 3.015 Rotation Flap Technique 55 / 3.016 Advancement Flap Technique from Both Temporal Areas 55 / 3.017 Double Rotation Flap 56.- 3.018 Nose.- 3.019 Transposition Flap Technique 57 / 3.020 Double Transposition Flap Technique 58 / 3.021 Lateral Advancement Flap Technique 58 / 3.022 Cranial Advancement Flap Technique 59 / 3.023 Caudal Advancement Flap Technique 59 / 3.024 Rotation Flap Technique for Defects of Ala Nasi 59 / 3.025 Rotation Flap Technique for Defects of the Nasal Tip 61 / 3.026 Tunnel Flap Technique 61 / 3.027 Columella Nasi Reconstruction Technique 62 / 3.028 Island Flap Technique 62 / 3.029 Composite Grafts 62 / 3.030 Z-Flap Technique 63 / 3.031 Free Skin Grafting 63-/-3.032 Rhinophyma Therapy 63.- 3.033 Lips.- 3.034 Vermilionectomy for the Lower Lip (Langenbeck and von Bruns) 64 / 3.035 Triangular Excision 65 / 3.036 Advancement Flap Techniques for the Lower Lip (von Burow) 66 / 3.037 Lower Lip Repair (Estlander) 66 / 3.038 Transposition Flap Technique for Defects of the Lower Lip 67 / 3.039 VY-Flap Technique 67 / 3.040 Plastic Surgery to Widen the Mouth 68 / 3.041 Transposition Flap Technique for Upper Lip Repair 68 / 3.042 Advancement Flap Technique (von Burow) for Upper Lip Repair 68 / 3.043 Lower Lip Repair (Spiessl) 69 / 3.044 Surgical Therapy for Cheilitis Granulomatosa (Melkersson-Rosenthal Syndrome) 69 / 3.045 Correction of Thin Labium 70.- 3.046 Eyelids.- 3.047 Advancement Flap Technique (Inner Canthus) 70 / 3.048 Transposition Flap Technique (Inner Canthus) 71 / 3.049 Advancement-Rotation Flap Technique (Upper Eyelid) 71 / 3.050 Advancement Flap Technique (Lower Eyelid) 71 / 3.051 Rotation Flap Technique (Imre) 71 / 3.052 Transposition Flap Technique (Lower Eyelid) 72 / 3.053 Correction for Baggy Eyelids (Blepharoplasty) 72.- 3.054 Cheeks.- 3.055 Advancement Flap Technique 75 / 3.056 Transposition Flap Technique 75 / 3.057 Rotation Flap Technique 75.- 3.058 Auricle, Pre- and Postauriclar Region.- 3.059 Triangular Excision 75 / 3.060 Reduction Plasty of the Auricle (Trendelenburg) 76 / 3.061 Partial Amputation of the Auricle 76 / 3.062 Plastic Reconstruction of the Auricle for Partial Defects 79 / 3.063 Rotation Flap Technique 79 / 3.064 Transposition Flap Technique 79 / 3.065 Advancement Flap Technique 79 / 3.066 Tunnel Flap Technique 79 / 3.067 Chin, Throat, and Neck 79 / 3.068 Advancement Flap Technique 81 / 3.069 Rotation Flap Technique (Lateral Chin-Mandibular Area) 81 / 3.070 Rotation Flap Technique (Throat) 82 / 3.071 Double Rotation Flap Technique 82 / 3.072 Transposition Flap Technique 82.- 3.073 Trunk.- 3.074 Transposition Flap Technique 83 / 3.075 Rotation Flap Technique 83 / 3.076 Double Rotation Flap Technique 83 / 3.077 Free Skin Grafting Technique 83 / 3.078 Rehabilitation of Sagging Abdomen 84.- 3.079 Axilla.- 3.080 Transposition Flap Technique 85 / 3.081 Rotation Flap Technique 85 / 3.082 Surgical Therapy for Axillary Hyperhidrosis 85.- 3.083 Male Genital Region.- 3.084 Dorsal Incision 86 / 3.085 Circumcision 86 / 3.086 Phimosis Correction (Rebreyoud [385]) 87 / 3.087 Pedicled Flap Technique (Happle) 87 / 3.088 Amputation of the Penis 88 / 3.089 Repair of a Defect in the Scrotal Area 88 / 3.090 Free Skin Grafting Technique 88 / 3.091 Lymphangioplasty (Handley and Zieman [358, 570]) 88 / 3.092 Testicular Biopsy 89 / 3.093 Surgery of Varicocele 89.- 3.094 Female Genital Region.- 3.095 Vulvectomy.- 3.096 Extremities.- 3.097 Multiple Z Flaps 90 / 3.098 Transposition Flap Technique 90 / 3.099 Free Skin Grafting Technique 90 / 3.100 Surgical Therapy for Leg Ulcers 90.- 3.101 Hands and Feet.- 3.102 Free Skin Grafting Technique 92 / 3.103 Transposition Flap Technique 92 / 3.104 VY-Flap Technique 92 / 3.105 Multiple Z-Flap Technique 92 / 3.106 Dermabrasion 92 / 3.107 Nail Extraction 92 / 3.108 Nail Extraction Combined with Triangular Excision 92 / 3.109 Triangular Excision (Emmet) 92.- Plates.