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Living related hemi-face skin transplant using radial forearm free flap for a xeroderma pigmentosa patient: early outcome.

Amin A, Bassiouny M, Sallam K, Ghally G, El-Karaksy H, El-Haddad A - Head Neck Oncol (2010)

Bottom Line: In addition the girl did not develop skin lesions in the operated site.Our early cosmetic result was very promising.In addition to this, the girl did not develop skin lesions in the operated side of the face.

View Article: PubMed Central - HTML - PubMed

Affiliation: Surgical Oncology Department, National Cancer Instituite, Cairo, Egypt. aymanamin@hotmail.com

ABSTRACT

Introduction: Xeroderma pigmentosa (XP) is a hereditary disease characterized by deficient repair of DNA damage that occurred on exposure of the skin to ultraviolet irradiation. The affected children have a propensity to develop multiple skin cancers mainly in the face and eventually die before the age of 20.

Hypothesis: Allograft replacement of facial skin by a healthy skin from normal person might decrease the incidence of skin cancer development, the number of surgical procedures, and eventually might improve the survival of these miserable patients.

Methods: As Cadaveric organs are unavailable in our country. After approval from the ethical committee, confirmed agreement of the donor and the patient's guardian, a radial forearm free flap was transplanted from an ABO compatible mother to her 5 year old daughter with XP. The mother had an older daughter died from the same disease at the age of 14. The flap replaced skin of the hemi face that developed precancerous lesions. The girl was kept on adjusted doses of immunosuppressive drugs.

Results: The flap survived, wounds healed uneventfully. The flap developed a reddish spot one and half month following transplant where baseline skin biopsy was taken. In the fifth months the girl presented with bad non salvageable rejection that ended up loosing the flap. On long term follow up, the girl started to develop skin lesion on the virgin half of the face. Our early cosmetic result replacing half of the facial skin was very promising. In addition the girl did not develop skin lesions in the operated site.

Conclusion: Our early cosmetic result was very promising. In addition to this, the girl did not develop skin lesions in the operated side of the face.

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Related in: MedlinePlus

Side view showing the healthy radial forearm flap.
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Figure 2: Side view showing the healthy radial forearm flap.

Mentions: Surgical pathology of the excised skin showed foci of marked dysplasia and carcinoma in situ lesions. The flap survived the early postoperative period. The wounds healed uneventfully and the patient was discharged on a weekly outpatient visit for follow up (Figures 1, 2, 3). Immune suppression was done as planned as given in detail in the methods portion.


Living related hemi-face skin transplant using radial forearm free flap for a xeroderma pigmentosa patient: early outcome.

Amin A, Bassiouny M, Sallam K, Ghally G, El-Karaksy H, El-Haddad A - Head Neck Oncol (2010)

Side view showing the healthy radial forearm flap.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908605&req=5

Figure 2: Side view showing the healthy radial forearm flap.
Mentions: Surgical pathology of the excised skin showed foci of marked dysplasia and carcinoma in situ lesions. The flap survived the early postoperative period. The wounds healed uneventfully and the patient was discharged on a weekly outpatient visit for follow up (Figures 1, 2, 3). Immune suppression was done as planned as given in detail in the methods portion.

Bottom Line: In addition the girl did not develop skin lesions in the operated site.Our early cosmetic result was very promising.In addition to this, the girl did not develop skin lesions in the operated side of the face.

View Article: PubMed Central - HTML - PubMed

Affiliation: Surgical Oncology Department, National Cancer Instituite, Cairo, Egypt. aymanamin@hotmail.com

ABSTRACT

Introduction: Xeroderma pigmentosa (XP) is a hereditary disease characterized by deficient repair of DNA damage that occurred on exposure of the skin to ultraviolet irradiation. The affected children have a propensity to develop multiple skin cancers mainly in the face and eventually die before the age of 20.

Hypothesis: Allograft replacement of facial skin by a healthy skin from normal person might decrease the incidence of skin cancer development, the number of surgical procedures, and eventually might improve the survival of these miserable patients.

Methods: As Cadaveric organs are unavailable in our country. After approval from the ethical committee, confirmed agreement of the donor and the patient's guardian, a radial forearm free flap was transplanted from an ABO compatible mother to her 5 year old daughter with XP. The mother had an older daughter died from the same disease at the age of 14. The flap replaced skin of the hemi face that developed precancerous lesions. The girl was kept on adjusted doses of immunosuppressive drugs.

Results: The flap survived, wounds healed uneventfully. The flap developed a reddish spot one and half month following transplant where baseline skin biopsy was taken. In the fifth months the girl presented with bad non salvageable rejection that ended up loosing the flap. On long term follow up, the girl started to develop skin lesion on the virgin half of the face. Our early cosmetic result replacing half of the facial skin was very promising. In addition the girl did not develop skin lesions in the operated site.

Conclusion: Our early cosmetic result was very promising. In addition to this, the girl did not develop skin lesions in the operated side of the face.

Show MeSH
Related in: MedlinePlus