Korean Lepr Bull.
2013 Dec;46(1):41-48.
Clinical characteristics and Treatment of Paraffinomas in patients with Hansen disease
- Affiliations
-
- 1Department of Dermatology, VHS medical center, Korea.
- 2Korean Hansen Welfare Association, Korea.
- 3Ahn's Plastic and Aethetic surgery Clinic, Korea. pscliahn@hotmail.com
Abstract
- BACKGROUND
Ulnar nerve palsy in patients with Hansen disease causes hand wasting and atrophy. To masquerade these deformities, patients injected paraffin or silicone into the lesions, which results in paraffinomas. Several years later, painful inflammation, ulceration or abscesses may develop in the paraffinomas.
OBJECTIVE
To investigate the clinical characteristics of paraffinomas in patients with Hansen disease, and to evaluate and compare the effects of various surgical treatment methods of paraffinomas.
METHODS
Fifty-seven patients with paraffinomas were randomized to receive debridement(curettage) with primary closure, skin graft, skin flap, or second intention at the hospital of Korean Hansen Welfare Association from 1998 to 2012. We analyzed retrospectively the final cosmetic results of three methods, primary closure, skin graft, and skin flap, in 33 patients with more than 6 months follow-up. The final results were classified into 4 grades, excellent, good, fair, and poor.
RESULTS
Of 57 patients, the ratio of male and female was 42:15 and the average age was 73 and 71 years repectively. The location of the lesions was the hand and wrist in 54 patients and the face in 3. The total number of procedures was 72 and that of 3 methods was 55. In 33 patients, 19 showed above fair grades and the recurrence rate was 42%(14/33). There were no serious postoperative complications.
CONCLUSION
Wide and thorough curettage as debridement was very important to reduce recurrence and the primary closure was most efficient in consideration of an old age of patient, simplicity of procedure and cosmeosis.
