Daniel E. Gormley

Polydactylous Bowen's disease of the nail

We present three patients with Bowens disease of the fingernail folds and beds in which there was polydactylous involvement and add those to five similarly afflicted patients described by other authors. Bowens disease of the nail is a distinctive type of squamous cell carcinoma that differs from other variants. It is potentially an autochthonous process that can involve more than one nail with the passage of time. Seven-eighths of the patients described in this series were men. A majority had involvement of both hands. No metastases were seen.

Cutaneous surgery and the pregnant patient

Cutaneous surgery in 34 pregnant women is described. The main indication for surgery was the diagnosis and/or treatment of malignancy. Surgery during the period of organogenesis (15 to 56 days) should be avoided when possible. Patients should be positioned on the left side during the procedure to avoid the supine hypotensive syndrome. Monitoring of the fetal heartbeat is desirable. Local anesthetics, penicillin, and erythromycin are safe if used carefully. Acetaminophen is the analgesic of choice. Exposure to the sun should be avoided during the perioperative period.

Use of Burow's wedge principle for repair of wounds in or near the eyebrow

Burows wedge flap provides an excellent method for repair of wounds in or near the eyebrow. Advantages afforded by this technic in this context include ample flap elasticity and vascularization, versatility in dealing with wounds of varying dimension and location, and fewer incisions in comparison with the number necessary with other methods. Between 1980 and 1984 the author used this method in twelve patients and obtained good to excellent results in eleven and a fair outcome in one.