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Fournier's gangrene (FG) is a rare form of necrotizing fasciitis of the perineal, genital, or perianal region. It is characterized by an aggressive course and high mortality rate, over 20%. FG demands immediate treatment including resuscitation maneuvers, intravenous antibiotic therapy and early surgical debridement. Background/Objectives: The gold-standard treatment for FG is surgical reconstruction. However, up to date, no precise guidelines exist. Thus, we decided to systematically review the literature, focusing on FG contemporary approaches to reconstructive surgery, aiming to analyze the various reconstructive strategies and their specific indications. Methods: A systematic review was carried out according to the PRISMA statement by searching various databases from April 2014 to April 2024, using the terms "Fournier Gangrene OR Fournier Gangrene Reconstruction OR Fournier Gangrene Treatment OR Fournier Gangrene Plastic Surgery OR Necrotizing Fasciitis OR Necrotizing Fasciitis AND Reconstruction". The eligibility criteria included original studies aimed at discussing FG reconstruction with at least three clinical cases. Results: The final synthesis included 38 articles, and 576 reconstructions were described. Of these, 77.6% were minimally invasive strategies (direct closure, secondary healing, grafts, and local random flaps), while more invasive reconstructions (loco-regional flaps based on known vascular anatomy) were adopted in 22.4%. No free flaps were reported. Conclusions: FG requires immediate medical interventions including broad-spectrum antibiotic therapy, surgical debridement, adjuvant therapies, and reconstructive surgeries. Taking into account the anatomical characteristics of the inguinal-crural region, skin grafts and local random flaps could offer versatile and effective reconstructions for most FG cases, while the more invasive strategies should be reserved for very few cases. Future research is warranted to define an FG dedicated reconstruction protocol. [ABSTRACT FROM AUTHOR]

Periocular sebaceous carcinoma (PSC) is a rare, aggressive, and potentially metastatic adnexal malignancy. Due to the ability of PSC to resemble several benign and malignant conditions, diagnosis is often delayed or mistaken. In addition, even with a known diagnosis, choosing the right treatment is still an open debate. For this reason, we decided to review the most up‐to‐date literature on PSC and propose a dedicated procedural protocol to help clinicians when dealing with PSC. A PubMed search was carried out using the terms "Sebaceous Carcinoma", "Adnexal Periocular Cancer", "Sebaceous Carcinoma AND eyelid", "Periocular Sebaceous Carcinoma", and "Ocular Adnexa". Pertinent studies published in English from 1997 up to December 2022 were compared to the selection criteria and if suitable, included in this review. Through the initial search, 84 articles were selected. Of these, 36 were included in the final study. Several papers explored different diagnostic and therapeutic strategies regarding PSC diagnosis and management. In light of the current literature review and the multidisciplinary experience of three clinical centers, a dedicated procedural protocol is proposed. PSC diagnosis may be achieved through accurate clinical evaluation, but it requires histopathologic confirmation, which can be challenging. Dermoscopy, in vivo reflectance confocal microscopy, and optical coherence tomography may facilitate PSC clinical examination, while immunohistochemistry stains may support histological diagnosis. Appropriate disease staging is necessary before choosing the treatment, as local disease requires radically different treatment compared to advanced disease. In addition, recent innovations in nonsurgical treatments, including radio‐chemotherapy, immunotherapy, and targeted therapy, may be a viable option in the most challenging cases. [ABSTRACT FROM AUTHOR]

Simple Summary: Melanoma, the deadliest skin cancer, is a focus of research worldwide. This malignancy has been demonstrated to evade the immune system through several escape mechanisms. Among these, melanoma-related Dendritic Cells (DCs) alterations, particularly within the Sentinel Lymph Node (SLN), seem to play a key role. In SLNs, melanoma-related factors create a tumor microenvironment capable of impairing the immune response, inducing tolerance to tumor antigens and thus favoring SLN early metastases. The present literature review describes the interactions between Langerhans Cell (LC), a particular DC subset, and melanoma, suggesting a new potential therapeutic target. Background. Langerhans cells (LCs) are professional Dendritic Cells (DCs) involved in immunoregulatory functions. At the skin level, LCs are immature. In response to tissue injuries, they migrate to regional Lymph Nodes (LNs), reaching a full maturation state. Then, they become effective antigen-presenting cells (APCs) that induce anti-cancer responses. Notably, melanoma patients present several DC alterations in the Sentinel Lymph Node (SLN), where primary antitumoral immunity is generated. LCs are the most represented DCs subset in melanoma SLNs and are expected to play a key role in the anti-melanoma response. With this paper, we aim to review the current knowledge and future perspectives regarding LCs and melanoma. Methods. A systematic review was carried out according to the PRISMA statement using the PubMed (MEDLINE) library from January 2004 to January 2024, searching for original studies discussing LC in melanoma. Results. The final synthesis included 15 articles. Several papers revealed significant LCs–melanoma interactions. Conclusions. Melanoma immune escape mechanisms include SLN LC alterations, favoring LN metastasis arrival/homing and melanoma proliferation. The SLN LCs of melanoma patients are defective but not irreversibly, and their function may be restored by appropriate stimuli. Thus, LCs represent a promising target for future immunotherapeutic strategies and cancer vaccines. [ABSTRACT FROM AUTHOR]

Background: The regulatory landscape for plastic and cosmetic surgery across the country plays a crucial role in shaping the practices within its premises, ensuring patient safety, and maintaining ethical standards in the medical community. This review examines the distinct regulatory frameworks that govern Australia, United Kingdom (UK), and Italy practices, focusing on the nuances that influence the professional accountability and safety measures in place., Methods: A comprehensive scoping review was conducted, exploring the legal and regulatory frameworks governing plastic and reconstructive surgery in Australia, the UK, and Italy. Databases such as PubMed, Scopus, and Google Scholar were searched for relevant studies from infinity to May 2024, which were then analyzed to compare regulatory practices, qualification requirements, and their implications on patient safety and professional accountability., Results: Each country presents a unique set of regulations that reflect their individual medical, legal, and cultural contexts. In Australia, the Australian Health Practitioner Regulation Agency (AHPRA) and the Medical Board of Australia impose stringent criteria for differentiating between "cosmetic surgeons" and "plastic surgeons". The UK's approach, governed by the General Medical Council (GMC), emphasizes ethical conduct, informed consent, and transparent advertising. Italy's regulatory framework varies slightly with a specific focus on the qualifications and titles of practitioners., Conclusions: The study underscores the importance of stringent regulations in plastic and cosmetic surgery, advocating for enhanced regulatory measures and comprehensive education on the qualifications of practitioners. It is imperative that these standards are maintained and adapted as necessary to protect patients in the rapidly evolving landscape of cosmetic and plastic surgery across the different regions., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://gs.amegroups.com/article/view/10.21037/gs-24-244/coif). W.M.R. serves as an unpaid associate editor of Gland Surgery from March 2023 to February 2028. I.S. serves as an unpaid editorial board member of Gland Surgery from September 2023 to August 2025. The other authors have no conflicts of interest to declare., (2024 Gland Surgery. All rights reserved.)

Introduction: rhinoplasty traditionally represents a difficult challenge for plastic surgeons. The aim of this article is to describe our personal new graft ABLG (Alar base lining graft) in augmentation rhinoplasty, to treat and prevent alar retraction., Materials and Methods: in this study, we retrospectively reviewed patients treated with ABLG at our institution between July 2019 and April 2022. We described our personal technique and graft. At a minimum follow-up time of one year, post-operative pictures were taken, and patients were reassessed, evaluating aspects such as global symmetry, shape and contour of the nose, Finally, patients' satisfaction was investigated according to ROE questionnaire., Results: a total of 42 patients were included in the study. They reported a significant satisfactory aesthetic result in nasal image, as the mean postoperative ROE score shows. The alar contracture in secondary rhinoplasty was successfully treated. None of the grafts was extruded or collapsed. Wounds healed without reported major infection., Conclusion: this study has demonstrated that ABLG is a safe graft that contributes to improved functional and aesthetic outcomes, has a high patient satisfaction rate, and a low rate of post- operative complication., Competing Interests: Conflict of interest: None, (Copyright © 2024 by the American Society of Plastic Surgeons.)