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CRPS (complex regional pain syndrome) is well documented as a reflex sympathetic dystrophy. It mostly has been reported to occur in the extremities and has only been mentioned anecdotally in the breast after breast surgery or trauma of the chest wall. Recent literature describes a post-mastectomy pain syndrome (PMPS), which mimics CRPS symptoms and, despite the nomenclature, is not only limited to mastectomy procedures but also any other surgical procedure involving breast parenchyma. We report PMPS in a 39-year-old patient after revision operation of breast reduction surgery. Postoperatively, the patient showed symptoms of severe persistent pain, swelling, cutaneous temperature changes, and hyperhidrosis in the affected breast. Subcutaneous infiltration with triamcinolone acetonide and prilocaine only relieved the symptoms temporarily. Botox injections did not relieve her symptoms of sweating either. Two intercostal nerve branches were identified with ultrasonography and dissected in general anesthesia. This procedure relieved her symptoms. Surgeons should consider CRPS and PMPS as differential diagnosis of chronic disproportionate pain after breast surgery. Early identification and treatment will help alleviate persistent CRPS symptoms and avoid chronic soft tissue changes. Level of evidence: Level IV, diagnostic/therapeutic study.

Temporary or long-lasting loss of grip force after open carpal tunnel release (CTR) in carpal tunnel syndrome (CTS) patients is well known and caused by changes in biomechanical conditions through sectioning of the transverse carpal ligament. We hypothesize to find predicting factors for loss of grip strength. We performed dynamometer testing of overall hand grip, tip pinch, and key pinch grip prior, 3 and 6 months after open CTR in 42 CTS subjects. Changes in these three main variables related to pre-operative grip, tip pinch and key pinch forces as well as gender and age were analyzed for significant results (t test, Pearson and Spearman correlations, descriptive statistics; 2-tailed p = .05). At 3-month post-CTR, overall hand grip force decreased significantly by 11.7% (p = .006), whereas key pinch and tip pinch only decreased by 5.6 and 3.5% (p

Rosacea is a rather common and frequently diagnosed condition of the skin and may in some cases progress to rhinophyma. This is a case report of a patient with a giant rhinophyma of 358 g. He claimed his first symptoms 5 years prior to our first clinical assessment. We performed an excision of the tumor mass by scalpel and a CO2 laser treatment of the remaining skin surface. Post-surgical therapy only included topical treatment with an ointment containing bacitracin zinc and neomycin sulphate to prevent infections. After stable wound closure, we had the chance to examine the patient after a period of 7.5 years with remarkable aesthetical results. Level of Evidence: Level V, therapeutic study.