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BACKGROUND: We retrospectively evaluated all our cases of re-excised cutaneous squamous cell carcinomas (CSCCs) in the last 10 years to examine whether they change grade in re-excision histology reports. METHODS: The medical files of 525 patients, which had surgical excision of CSCCs in the Plastic Surgery Department of Aristotle University of Thessaloniki between January 2007 and December 2017 were retrospectively evaluated. All primary and recurrent tumours that were incompletely excised were included in the study. The tumour's grade of both the initial and re-excision histological reports (Broders classification: well, moderate, or poor), age, sex, tumour location, size, infiltration borders (deep or lateral), and perineural invasion was documented. RESULTS: From a total number of 525 CSCCs, 24 patients with 24 incompletely excised lesions were identified. Perineural invasion was noticed in 16 (66%) of patients. In 15 cases (62, 5%), poorer differentiation was recorded following re-excision (group A), whilst in nine patients (37, 5%), the grade remained the same (group B). No statistical significance was observed on age (P = 0.106), tumour size (P = 0.382) and perineural invasion (P = 0.658) in both groups. A positive correlation between male gender and infiltrated border location (deep) and change of grade was observed (P = 0.014, P = 0.000). CONCLUSIONS: We would strongly advise re-excision in incompletely excised lesions except in patients that are unwilling or unfit to undergo another surgical procedure as incompletely excised lesions may change into a poorer degree of differentiation in re-excision histology reports.

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BACKGROUND: Benign lesions of the breast in total are much more frequent than malignant ones. However, there are no epidemiologic data on the prevalence of benign or malignant tumours of the nipple, and the bibliography on benign nipple tumours in general is limited. AIMS: To present some rare cases of benign nipple tumours and review the literature. MATERIALS AND METHODS: Four cases of rare benign nipple tumours: neurofibromas, wart, leiomyoma and milium are presented. The literature search on benign nipple tumours was performed using MEDLINE, Pubmed, and Cochrane databases with limits: English language, human species and available abstract. The keyword used was 'benign nipple tumours'. RESULTS: The initial search retrieved 337 articles. The papers were reviewed and the articles that referred to benign lesions that appeared at the nipple specifically were identified. Different entities that were described included: neurofibroma, leiomyoma, milium, florid papillomatosis, syringomatous adenoma, nevoid hyperkeratosis, fibroma, pseudolymphoma and haemangioma. DISCUSSION: Differential diagnosis of benign tumours of the nipple can be demanding for the physicians. Many of the symptoms and signs like pruritus, serosanguinous discharge, lichenification, erosion and nodular enlargement are produced by either malignant or benign nipple lesions. Radiology can be unclear in the diagnosis of nipple abnormalities. CONCLUSION: Histological examination of the lesion can be the only definite answer in these cases.

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The electric fly-swatter is a household device used widely in Greece to kill mosquitoes. It consists of a racket-shaped electrical screen which is free of toxic and other chemicals. When the screen touches the insects, the contact generates an electric flash of light and the insects are incinerated. We present the case of a 15% flame burn caused by the flash of light produced by an electric fly-swatter. According to our review of the literature, this is the second case of burn injury caused by an electric fly swatter.

Le chasse-mouches électrique est un appareil ménager largement utilisé en Grèce pour tuer les moustiques. Il se compose d'un écran électrique en forme de raquette, qui est exempt de produits chimiques toxiques. Lorsque l'écran touche les insectes, le contact génère un flash électrique de la lumière et les insectes sont incinérés. Nous présentons le cas d'une brûlure sur 15% de la surface corporelle causée par le flash de lumière produite par une tapette à mouche électrique. Selon notre revue de la littérature, c'est le deuxième cas de brûlure causée par une tapette à mouche électrique.

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BACKGROUND: This article provides an algorithm for achieving an aesthetically pleasing nipple-areola complex in cases of skin-sparing mastectomy and immediate reconstruction METHODS: If the contralateral nipple was big enough and the nipple-sharing technique could be used in the future for reconstruction, we left a round skin paddle at the time of the skin-sparing mastectomy and immediate flap reconstruction. The diameter of the round skin paddle was approximately the same as the contralateral areola. For nipple reconstruction we placed the graft from the contralateral nipple in the middle of the aforementioned skin paddle. If the contralateral nipple was not sufficiently large for use as a donor, then the C-V flap was used for nipple reconstruction. In these cases we deliberately left an oval skin paddle when the skin-sparing mastectomy and immediate flap reconstruction were performed. The short diameter of the oval skin paddle was approximately the same as the diameter of the contralateral areola. The position and the height of the C-V flap were marked in order to transform the oval skin paddle to a round one when the donor site of the C-V flap was closed. RESULTS: Following this algorithm an optical illusion of a nipple-areola complex that is similar to the contralateral normal one is created. CONCLUSION: From our experience this algorithm can help create an aesthetically pleasing nipple-areola complex and also provides a ready pattern to our tattoing experts for the dermatography of the nipple-areola complex.

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Dermatography has been used in medicine both for aesthetic purposes as permanent make-up or for coverage of scars, defects and skin colour abnormalities. These procedures demand skill and usually more than one session to achieve the desired result. We present an innovative idea from some of our plastic surgery patients to camouflage their scars using decorative tattooing done by non-medical professional tattooists. Long abdominal scars were covered with symmetrical tattoo designs rendering the scars inconspicuous even on close inspection. As tattooing is less of a social taboo nowadays and, indeed, quite acceptable among many of the younger generations, this method could be presented as an option to camouflage scars of the trunk and the limbs that are unacceptable or undesirable, especially in patients who already have tattoos on other parts of their bodies.

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The admission and follow-up chest radiographs as well as the follow-up CT scans of 13 burn patients admitted to our clinic requiring ventilatory support were analysed for signs of inhalation injury and pulmonary complications. The findings were compared with the results of the clinical examination, the blood gas tests, and bronchoscopy. Eleven out of the 13 patients underwent bronchoscopy revealing inhalation injury. The CT scan detected pleural effusion in two patients with a normal chest radiograph. In two patients the CT scan detected asymmetrical expansion between the right lung and the left. In one patient soft tissue oedema made evaluation of the chest radiograph impossible, while the CT revealed bilateral pleural effusions and consolidations or atelectasis in both the lower lobes. In one patient the CT scan detected oedema of consolidatory pattern in every lobe (superior middle-inferior), while the image in the chest radiograph was not similar. CT identified an area of consolidation in one patient in the right middle lobe with a normal chest radiograph. The results of the CT scan correlated with the clinical course and blood gas determinations, while similar findings in the chest radiograph were observed at a later stage. In conclusion, compared to chest radiographs, the CT scan often yielded additional information in the follow-up of intubated burn patients with inhalation injury. It can be performed in order to confirm and/or more precisely define the full extent of lung injury and is also feasible in patients who are critically ill and hard to move.