Open versus Closed Surgery for Axillary Osmidrosis: A Meta-Analysis of Articles Published in Four Languages

( Misako Nomura ),( Daichi Morioka ),( Yasutaka Kojima ),( Ryutaro Tanaka ),( Koichi Kadomatsu ) 대한피부과학회 2020 Annals of Dermatology Vol.32 No.6

Background: Individuals with axillary osmidrosis suffer detrimental effects to their psychosocial functioning. In Asian nations, major operations for axillary osmidrosis include subdermal excision (open surgery) and suction-curettage (closed surgery). Objective: The aim of this meta-analysis was to determine which of these two procedures is most favorable in terms of safety and efficacy. Methods: According to the Preferred Reporting Items for Systematic Reviews and Metaanalyses (PRISMA) guideline, we searched electronic databases for articles published in English, Japanese, Korean, and Chinese languages. Fixed-effects model meta-analyses of odds ratios (OR) and 95% confidence intervals (CI) were conducted, and the I² was used to assess heterogeneity. Complication rates, recurrence/ineffectiveness rates, and patient satisfaction data were extracted and compared between open and closed surgeries. Results: Our search yielded 8 articles that include 1,179 patients; 560 underwent open surgery, and 619 underwent closed surgery. Our meta-analysis revealed that suction-curettage had a significantly lower risk of acute adverse events than open excision (OR, 0.15; 95% CI, 0.07∼0.32), whereas open excision was significantly superior to suction-curettage for recurrence/ineffectiveness rate (OR, 2.90; 95% CI, 1.37∼6.15). Patient satisfaction was equally high with both treatments (OR, 1.58; 95% CI, 0.69∼ 3.60). Conclusion: Since surgical treatments for axillary osmidrosis have been performed mostly in East Asian nations, it was meaningful to review articles published in four languages. This meta-analysis revealed that closed surgery was safer but less effective than open surgery. However, both patient groups expressed high satisfaction with the outcomes. Our results may be helpful for deciding surgical treatment options. (Ann Dermatol 32(6) 487∼495, 2020)

Earwax of patients with hidradenitis suppurativa: A retrospective study

Yuka Shibuya,Daichi Morioka,Misako Nomura,Zhuo Zhang,Hiroki Utsunomiya 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.6

Background In Western nations, hidradenitis suppurativa (HS) typically affects the apocrinegland-bearing skin of people of African origin, women, smokers, and individuals with obesity. The clinical characteristics of HS in Korea and Japan, however, are reportedly different fromthose in the West. We therefore hypothesized that wet earwax is associated with HS becausemost East Asian people are genetically predisposed to produce dry earwax. Methods The medical charts of 53 Japanese patients with HS were reviewed retrospectively. Results Unlike the results of surveys conducted in Western nations, most of our patientswere men (72%), whose buttocks were the most commonly affected site. Apocrine glandbearingareas, such as the axilla, were affected less often. The proportion of HS patients withwet earwax was 51%, which was substantially higher than that found in the general Japanesepopulation. Moreover, when patients with gluteal HS were excluded, the proportion ofpatients with wet earwax became even higher (68%). Conclusions Although the etiology of HS is unknown, our survey indicated that HS in apocrinegland-bearing skin, such as the axillary and anogenital areas, may be associated withwet earwax. As this study was conducted in a limited clinical setting, a nationwide, multicentersurvey is warranted to clarify the clinical characteristics of HS in Japan.

Earwax of patients with hidradenitis suppurativa: A retrospective study

Shibuya, Yuka,Morioka, Daichi,Nomura, Misako,Zhang, Zhuo,Utsunomiya, Hiroki Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.6

Background In Western nations, hidradenitis suppurativa (HS) typically affects the apocrine gland-bearing skin of people of African origin, women, smokers, and individuals with obesity. The clinical characteristics of HS in Korea and Japan, however, are reportedly different from those in the West. We therefore hypothesized that wet earwax is associated with HS because most East Asian people are genetically predisposed to produce dry earwax. Methods The medical charts of 53 Japanese patients with HS were reviewed retrospectively. Results Unlike the results of surveys conducted in Western nations, most of our patients were men (72%), whose buttocks were the most commonly affected site. Apocrine gland-bearing areas, such as the axilla, were affected less often. The proportion of HS patients with wet earwax was 51%, which was substantially higher than that found in the general Japanese population. Moreover, when patients with gluteal HS were excluded, the proportion of patients with wet earwax became even higher (68%). Conclusions Although the etiology of HS is unknown, our survey indicated that HS in apocrine gland-bearing skin, such as the axillary and anogenital areas, may be associated with wet earwax. As this study was conducted in a limited clinical setting, a nationwide, multicenter survey is warranted to clarify the clinical characteristics of HS in Japan.

Eruption of a venous malformation through an iliac bone harvesting site after trauma

Kono, Tatsuki,Saiga, Atsuomi,Tamagawa, Keiichi,Katsuki, Kensuke,Nomura, Misako,Hokazono, Toshinori,Uchida, Yuuki Korean Society of Plastic and Reconstructive Surge 2018 Archives of Plastic Surgery Vol.45 No.6

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation (VM). Based on the patient's clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.

Eruption of a venous malformation through an iliac bone harvesting site after trauma

Tatsuki Kono,Atsuomi Saiga,Keiichi Tamagawa,Kensuke Katsuki,Misako Nomura,Toshinori Hokazono,Yuuki Uchida 대한성형외과학회 2018 Archives of Plastic Surgery Vol.45 No.6

Harvesting grafts from the anterior iliac bone has been associated with various complications. A 50-year-old woman presented to our department with a chief complaint of right inguinal swelling and pain. Autologous bone grafts had been harvested on two previous occasions from the right anterior iliac crest for use in the reconstruction of multiple facial fractures. Computed tomography and magnetic resonance imaging revealed a full-thickness bone defect in the right anterior iliac crest. A mass was noted in the right gluteus minimus, while a multilocular cystic mass extended from the right iliac crest defect to the right inguinal region. Both the inguinal mass and gluteal mass were removed under general anesthesia. Following histopathological analysis, the gluteal mass was diagnosed as a venous malformation (VM). Based on the patient’s clinical course, iliac bone graft harvesting and trauma to the gluteal region triggered hemorrhaging from the VM. Blood components leaked out from the fragile portion of the iliac bone defect, forming a cystic lesion that developed into the inguinal mass. In this case, a coincidental VM resulted in a rare complication of iliac bone graft harvesting. These sequelae could have been avoided by planning for more appropriate ways to collect the grafts.