Biomedical subjects
Publications and source records attributed to A J Emmett.
This series of 37 cases treated by the author over a twenty-seven year period, covers the full spectrum of deformity produced by this condition. These include simple ring constrictions, those with a distal atrophy or oedema, digit fusions, and amputations.
A total of 2277 basal cell carcinomas (BCC) treated by surgical excision over a twenty-year period has been followed and analysed into clinical and histopathological type. This paper documents the incidence of different BCC types and points to the importance of the infiltrating, morphoeic and multifocal types. Many BCC are of one homogeneous histopathological type, although others have important secondary characteristics which may not be obvious clinically. We reserve the use of the word 'infiltrating' for BCC types which show microscopically the following characteristics: areas with lack of palisading; small cell clumps; and spiky thin cords of cells projecting out with loose stroma. These may penetrate far and wide along tissue planes and nerves, producing recurrence and spread, despite apparently adequate excision. The infiltrating BCC may also occur secondarily with other primary BCC types, accounting for their--at times--unexpectedly severe effects.
Shave excision is a useful technique for the treatment of superficial solar lesions. The most common of these is the solar keratosis, which can be a red or gray scaling lesion. This can at times be difficult to differentiate from the superficial basal cell carcinoma or squamous cell carcinoma or their more infiltrating types. Shave excision gives the advantage of a histopathologic report. Lesions found to be infiltrating or in danger of recurrence can then be further excised. The cosmetic appearance of the healed shave excision site is generally quite good, although it can be paler than the surrounding skin. If this is likely to be a problem, the shave graft can be applied, as with deeper shave excisions. A thin shave graft also can be used to repigment pale scarred areas. A series of 1313 shave excised lesions is analyzed.
The injection of corticosteroids into the skin results in the appearance of granular material in the dermis which usually disappears within 2 weeks of the injection. In one of two unusual reactions recently seen by us, there was a granulomatous foreign-body response to injected corticosteroid, whereas in the second there was a granulomatous reaction that resembled rheumatoid nodule.
Explore the source record for details and available documents.
We report two patients with angiosarcoma of the skin, a rare tumour in Queensland. Both presented on the face of elderly people; both were misdiagnosed as the more common skin cancers: basal cell carcinoma in one instance, and squamous cell carcinoma in the other. Frozen section histological examination diagnosis presented difficulty in both patients. Both tumours invaded very deeply requiring wide resection and reconstruction. One metastasized to the lungs, the other to the regional nodes.
Explore the source record for details and available documents.
An analysis is presented of a referred series of 1411 basal cell carcinomas treated by surgical excision and plastic surgical repair in which 259 were recurrent after previous other treatments. Of the 1,411 BCCs treated there were 10 BCCs which recurred (0.7% recurrence rate). A further 10 BCCs were primarily re-excised because of inadequate clearance around the tumour found on histological examination. (0.7% primary re-excision). The cases recurrent after previous treatment did not behave badly in terms of subsequent recurrence as they were widely excised and carefully observed in the postoperative years. Surgery must aim to be curative. We clearly define the tumour margin using magnification and mark an adequate clearance of surrounding normal tissue. This is then excised in width and depth. Repair of the defect is carried out to restore the area to as near normal as possible. Surgical repair is able to bring new tissue into the area to further enable it to withstand the rigours of the climate and not leave behind a premalignant scarred area.
Explore the source record for details and available documents.
Triangular flaps with subcutaneous pedicles have been consistently reliable for closing many defects in our 12-year experience. Before, we used mainly the lateral subcutaneous pedicles, but now we tend to use central pedicles. One can also leave partial skin bridges in the pedicles to prevent circular scar patterns, where the latter are undesirable.
The 4 V-flap technique for repair of preputial stenosis meets a need for an alternative to circumcision in the repair of phimosis. It is especially useful in cases where the penis is small and all available tissue should be retained. we have used the method for 3 years and have had no complications. On occasion, we have used 6 or 8 V-flaps, but we find the 4 V-flap repair is usually simpler and equally effective.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.