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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research
Ferra Olivia Mawu
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Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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The Rhomboid Flap for Facial Reconstruction Following Basal Cell Carcinoma Excision: A Case Report on Achieving Optimal Aesthetic and Functional Outcomes Tilesky Caprizio Phoanda; Ferra Olivia Mawu; Oktavia Reymond Leomer Sondakh; Paulus Mario Christopher
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1401

Abstract

Background: Reconstruction of the lower eyelid following oncologic surgery presents a formidable challenge due to the region's unique anatomy and functional importance. The primary goal is to restore the lamellar structure while avoiding ectropion, a complication with significant functional and aesthetic consequences. This report details the successful application of a rhomboid flap, a classic transposition flap, for a moderate-sized defect in this high-risk anatomical subunit. Case presentation: A 75-year-old male farmer presented with a 2x1 cm nodular basal cell carcinoma on his left lower eyelid. After surgical excision with 4 mm margins, a superolaterally based rhomboid flap was designed to close the defect. The procedure was performed under local anesthesia. The postoperative course was uncomplicated. Objective functional assessment at 12 weeks confirmed a normal lower lid position with margin-to-reflex distance 2 (MRD2) symmetrical to the contralateral eye and no evidence of ectropion or lagophthalmos. The cosmetic outcome was assessed as favorable using the Patient and Observer Scar Assessment Scale (POSAS), and the patient reported high satisfaction (5/5 on a Likert scale). Conclusion: This case report illustrates the successful use of a rhomboid flap for a moderate-sized lower eyelid defect, resulting in a favorable functional and aesthetic outcome without complications in the short-term follow-up period. The technique successfully restored tissue volume and preserved normal eyelid function, critically preventing ectropion. It supports the rhomboid flap as a robust and reliable option in the reconstructive surgeon's toolkit for this challenging anatomical area.
The Rhomboid Flap for Facial Reconstruction Following Basal Cell Carcinoma Excision: A Case Report on Achieving Optimal Aesthetic and Functional Outcomes Tilesky Caprizio Phoanda; Ferra Olivia Mawu; Oktavia Reymond Leomer Sondakh; Paulus Mario Christopher
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1401

Abstract

Background: Reconstruction of the lower eyelid following oncologic surgery presents a formidable challenge due to the region's unique anatomy and functional importance. The primary goal is to restore the lamellar structure while avoiding ectropion, a complication with significant functional and aesthetic consequences. This report details the successful application of a rhomboid flap, a classic transposition flap, for a moderate-sized defect in this high-risk anatomical subunit. Case presentation: A 75-year-old male farmer presented with a 2x1 cm nodular basal cell carcinoma on his left lower eyelid. After surgical excision with 4 mm margins, a superolaterally based rhomboid flap was designed to close the defect. The procedure was performed under local anesthesia. The postoperative course was uncomplicated. Objective functional assessment at 12 weeks confirmed a normal lower lid position with margin-to-reflex distance 2 (MRD2) symmetrical to the contralateral eye and no evidence of ectropion or lagophthalmos. The cosmetic outcome was assessed as favorable using the Patient and Observer Scar Assessment Scale (POSAS), and the patient reported high satisfaction (5/5 on a Likert scale). Conclusion: This case report illustrates the successful use of a rhomboid flap for a moderate-sized lower eyelid defect, resulting in a favorable functional and aesthetic outcome without complications in the short-term follow-up period. The technique successfully restored tissue volume and preserved normal eyelid function, critically preventing ectropion. It supports the rhomboid flap as a robust and reliable option in the reconstructive surgeon's toolkit for this challenging anatomical area.
Complete Clinical and Trichoscopic Remission of Refractory Patch Alopecia Areata with a Multi-Modal Microneedling and Vitamin D3 Protocol: A Case Report Stephanie Lukita; Ferra Olivia Mawu; Thigita Aga Pandaleke
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1493

Abstract

Background: Refractory patch alopecia areata (AA) presents a significant therapeutic challenge, as many patients fail first-line treatments. This gap necessitates the exploration of novel, mechanistically-targeted therapeutic strategies. Case presentation: We present the case of a 44-year-old female with a 2.5 × 3.0 cm patch of AA, refractory to a 3-month compliant trial of topical 0.25% desoximetasone and 5% minoxidil. Baseline diagnostics included histopathology (peribulbar lymphocytic infiltrate), quantitative trichoscopy (yellow dots, black dots, exclamation mark hairs), and laboratory workup, which revealed a serum 25-hydroxyvitamin D [25(OH)D] insufficiency (18.2 ng/mL). A multi-modal protocol was initiated: (1) systemic 5,000 IU/day oral cholecalciferol, (2) 10 sessions of 1.5 mm microneedling at two-week intervals, and (3) immediate post-procedure application of topical 100,000 IU cholecalciferol. Significant regrowth of pigmented terminal hairs was observed by week 12. After 20 weeks (10 sessions), complete clinical regrowth was achieved. Final quantitative trichoscopy confirmed the full resolution of all pathological markers, with a healthy density of terminal hairs. The patient’s systemic 25(OH)D level was corrected to 41.5 ng/mL. The treatment was well-tolerated. Conclusion: This case report documents a complete remission associated with a multi-modal protocol. The contribution of the systemic vitamin D repletion is a major, unresolvable confounder, making attribution impossible. However, this hypothesis-generating case suggests a combined (systemic, physical, and topical) approach may represent a potential rescue strategy for refractory patch AA, warranting further controlled investigation.
Complete Clinical and Trichoscopic Remission of Refractory Patch Alopecia Areata with a Multi-Modal Microneedling and Vitamin D3 Protocol: A Case Report Stephanie Lukita; Ferra Olivia Mawu; Thigita Aga Pandaleke
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i1.1493

Abstract

Background: Refractory patch alopecia areata (AA) presents a significant therapeutic challenge, as many patients fail first-line treatments. This gap necessitates the exploration of novel, mechanistically-targeted therapeutic strategies. Case presentation: We present the case of a 44-year-old female with a 2.5 × 3.0 cm patch of AA, refractory to a 3-month compliant trial of topical 0.25% desoximetasone and 5% minoxidil. Baseline diagnostics included histopathology (peribulbar lymphocytic infiltrate), quantitative trichoscopy (yellow dots, black dots, exclamation mark hairs), and laboratory workup, which revealed a serum 25-hydroxyvitamin D [25(OH)D] insufficiency (18.2 ng/mL). A multi-modal protocol was initiated: (1) systemic 5,000 IU/day oral cholecalciferol, (2) 10 sessions of 1.5 mm microneedling at two-week intervals, and (3) immediate post-procedure application of topical 100,000 IU cholecalciferol. Significant regrowth of pigmented terminal hairs was observed by week 12. After 20 weeks (10 sessions), complete clinical regrowth was achieved. Final quantitative trichoscopy confirmed the full resolution of all pathological markers, with a healthy density of terminal hairs. The patient’s systemic 25(OH)D level was corrected to 41.5 ng/mL. The treatment was well-tolerated. Conclusion: This case report documents a complete remission associated with a multi-modal protocol. The contribution of the systemic vitamin D repletion is a major, unresolvable confounder, making attribution impossible. However, this hypothesis-generating case suggests a combined (systemic, physical, and topical) approach may represent a potential rescue strategy for refractory patch AA, warranting further controlled investigation.
Co-Authors Oktavia Reymond Leomer Sondakh Paulus Mario Christopher Stephanie Lukita Thigita Aga Pandaleke Tilesky Caprizio Phoanda