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Arch Hand Microsurg > Volume 19(2); 2010 > Article
Journal of the Korean Society for Surgery of the Hand 2010;19(2):97-100.
Published online November 30, 2010.
DOI: https://doi.org/10.12790/jkssh.2010.19.2.97   
Pedicled Deep Inferior Epigastric Perforator Flap for Treatment of Dystrophic Epidermolysis Bullosa-Associated Squamous Cell Carcinoma in the Groin: Case Report
Kyung Pil Kim, M.D., Ji Hoon Kim, M.D., Eui Sik Kim, M.D, Ph.D., Jae Ha Hwang, M.D., Ph.D., Kwang Seog Kim, M.D., Ph.D., Sam Yong Lee, M.D., Ph.D.
Department of Plastic and Reconstructive Surgery, Chonnam National University Medical School, Gwangju, Korea. pskim@chonnam.ac.kr
심부하복벽동맥 천공지 유경 피판을 이용한 이영양성 수포성 표피박리증에 합병된 서혜부 편평 세포 상피암의 치료 - 증례 보고 -
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Abstract
Purpose: Epidermolysis bullosa is a rare genetic disease, characterized by the presence of extremely fragile skin and formation of recurrent blister resulting from even a minor mechanical injury. Squamous cell carcinoma (SCC) is recognized as a complication of the chronic scarring associated with dystrophic epidermolysis bullosa (DEB). When a soft tissue defect happens in a patient with epidermolysis bullosa, it is difficult to cover it with a skin graft or a flap. We describe the successful use of a pedicled deep inferior epigastric perforator flap for the reconstruction of SCC associated with DEB in the groin.
Methods: A 29-year-old man diagnosed with DEB at birth sustained an ulcer increasing in the right groin for the last 7 months. Under general anesthesia, the mass lesion and lymph nodes were removed and the resulting defect was covered with a pedicled deep inferior epigastric perforator flap.
Results: The flap survived completely and his postoperative course was uneventful. Histopathological examination revealed a SCC in the right groin and malignant tumor cells in the removed lymph nodes as well. Additional positron emission tomogram showed a malignant lesion in the ileocecal area with regional lymph node metastasis. The patient was referred to an oncologist for chemotheraphy, but the patient refused to take it. During a 4-month follow-up period, there was no recurrence in the right groin.
Conclusion: We suggest that perforator flaps can be considered as a reliable alternative for the reconstruction of soft tissue defects in a patient with DEB.
Key Words: Dystrophic epidermolysis bullosa, Squamous cell carcinoma, Perforator flap
 
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