PubMed · 13974100
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P RITZENFELD. 1962-11-29. [On dermis-epidermis junction].. https://doi.org/10.1007/bf00693557
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In his paper entitled "The reversed dermis flap" published in 1978, Pakiam explained the advantages of de-epithelialising local flaps and applying them dermis-side down. We present a ten-year series of 107-reversed dermis flaps used to raise depressed scars. There have been no significant complications in this series except two cases of infection and six cases of postoperative haematoma. All patients were satisfied with the cosmetic outcome. We do not use this flap as much as we used to since Coleman demonstrated how efficient lipostructure could be especially when applied to thin depressed scars. The reversed dermis flap remains invaluable in cases of widespread scars or when lipostructure is dangerous or impossible.
In this work, we compared the performance of objectives with similar numerical aperture of 0.75 but different immersion media of air, water, glycerin, and oil in the imaging of human skin epithelium and dermis. In general, we found that the oil immersion objective recorded the strongest intensity at the same mechanical depth. We also characterized the focal shifts and found that with decreasing refractive index, the focal shift becomes increasingly more negative (for both the epithelium and dermis). In imaging the dermis, we estimated the image resolution at the depths of 18.8 and 30.2 microm, and found that the image resolution were comparable at these depths under the four types of immersion conditions. Our results demonstrate that by changing the immersion media, the main microscopic imaging effects are the recorded axial intensities and the focal shifts. The effects on the image resolution are negligible.
Here, a case of a rare epithelial sheath neuroma (ESN) is reported. A 49-year-old white female presented with a 5 mm solitary, slightly raised, erythematous, itchy papule on her right upper back. The clinical impression was consistent with an inflamed nevus. The patient had no past medical history of malignancy or a family history of neurofibromatosis. There was no prior trauma, surgical procedures, or skin disease at the site. After excision, the patient has had no recurrence at the surgery site during a 4-months follow-up period. ESN is characterized by enlarged nerve fibers ensheathed by a sometimes keratinized squamous epithelium located in the superficial dermis where large nerves are not normally found. It is believed to be a benign neoplasm and simple excision is curative. The histologic differential diagnosis of ESN is presented, and possible mechanisms of its pathogenesis are discussed. It is important for the pathologist and dermatologist to be cognizant of this lesion to prevent misdiagnosis of perineural invasion.