Summary
Background
Purpura fulminans (PF) is a rare syndrome of intravascular thrombosis and haemorrhagic
infarction of the skin. The initial symptom of PF is peripheral purpura which progresses
to necrosis very rapidly. The prognosis of PF is poor, and the mortality is reported
to be around 40%. Even if the patient survives, the patient may require amputation
or reconstruction for limbs and facial necrosis.
Case report
A 48-year-old male suffered from PF following a left cerebellopontine angle tumour
excision. His nose and upper lip fell into necrosis afterwards. We performed nose
and upper lip reconstruction at 8 months after the onset. We used a forehead flap
for the nasal reconstruction and a free forearm flap for the lining. His upper lip
was reconstructed with bilateral nasolabial orbicularis oris myocutaneous flaps.
Results
The colour and texture match of the reconstructed nose and lip is good. He could open
his mouth wide enough and close completely.
Conclusions
Facial reconstruction after PF is very difficult, because the patient has extensive
scarring around the defect and there is little intact facial tissue. However, we performed
a facial reconstruction using local flaps as much as possible, and obtained good results.
Keywords
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Article info
Publication history
Published online: July 28, 2011
Accepted:
July 4,
2011
Received:
March 30,
2011
Identification
Copyright
© 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
