Refractory Human Cutaneous Protothecosis

A 67-year-old Scottish woman presented to her general practitioner with a subcentimeter lump between her shoulder blades. The lump was suspected to be an epidermal cyst and was excised. The patient had a history of controlled diabetes. Most summers, she spent a month near a beach resort in Mexico. The lump reappeared after 6 months within the scar area and was re- excised. Both skin excisions were performed in the primary care setting without histologic assessment.

The use of chloramphenicol ointment as an adhesive for replacement of the nail plate after simple nail bed repairs

Fingertip injuries are common and are often repaired. The nail plate is replaced to protect the repair and maintain the alignment of the nail bed edges after repair. Once replaced, this can be secured by any means and often a suture is used. We advocate that a small bleb of chloramphenicol provides a simple method of securing the nail plate. It is fast, easy and secure. In addition it provides an antibacterial effect, which may be of some benefit.

Basal cell carcinomas: do they need to be followed up?

Basal cell carcinoma (BCC) is the commonest of the malignant skin tumours. The follow-up of patients following excision of these lesions varies immensely. The aim of this study was to assess the need for outpatient follow-up of patients who had a primary BCC excised. A retrospective study was performed using the case notes of 206 patients who had a primary BCC excised in Bangour General Hospital in the years 1986 and 1987. Fourteen were excluded from the study, leaving 192 patients with 215 lesions. The overall recurrence rate was 5.1% with 39% of lesions recurring if the tumour was incompletely excised compared with 1% if it was excised completely. Complete excision is therefore the key to surgical control and we feel that there is no need to follow up patients routinely if the BCC has been completely excised.