Combined hinge flap full-thickness skin graft for a through-and-through nasal defect.

摘要

A 60-year-old Caucasian man presented with a through-and-through nasal defect of the right anterior nasal ala. The defect was subsequent to use of an Internet-purchased "black salve" ointment applied to a self-diagnosed basal cell carcinoma. At the time of physical examination there was a 0.9 x 0.7-cm hole in the right anterior nasal ala (Figure 1), and the surrounding skin appeared shiny, telangiectatic, and sclerotic.In addition there were multiple untreated basal cell carcinomas on the patient's forehead, cheeks, and lower right eyelid. Multiple punch biopsies were performed on the skin surrounding the nasal defect to detect any residual basal cell carcinoma that may have occurred after treatment with the black salve. The biopsies revealed scar tissue with no residual malignancy. How would you reconstruct this defect?