Related Experiment Video
Updated: Sep 22, 2025
The Superficial Inferior Epigastric Artery Fascia Flap for Nerve Reconstruction in Rabbits
Published on: June 13, 2025
Ulnar Artery Perforator Adiposal Flap for Paraffinoma Treatment in a Patient With Leprosy: A Case Report
Yukiko Morimoto1, Yusuke Sogabe1, Akira Kawabata1
1Department of Orthopaedic Surgery, Yodogawa Christian Hospital, Kunijima, Higashiyodogawa-ku, Osaka, Japan.
Abstract:
Leprosy is a chronic infection in humans that mainly affects the peripheral nerves and skin. Paraffin filling has been previously used for muscle atrophy treatment. However, the formation of paraffin granulomas (paraffinomas) can occur over the long term. We encountered a patient with leprosy who had hypothenar muscle atrophy caused by ulnar neuropathy. The patient was treated with paraffin injection at the hypothenar site for cosmetic appearance 60 years ago. Consequently, the paraffin formed a paraffinoma and a recurrent infected skin ulcer. Thus, paraffinoma removal and transfer of ulnar artery perforator adiposal flap (140 × 20 mm) were performed. The ulnar artery perforator adiposal flap was used for infection control and filling the dead space after paraffin removal. The skin healed without complications. Ultrasound confirmed residual adipose tissue and blood flow at the last follow-up.
Insights
Leprosy patients with paraffinomas from cosmetic injections may develop infected ulcers. Surgical removal of paraffinomas and reconstruction with an adiposal flap successfully treated the condition.
Area of Science:
- Plastic Surgery
- Dermatology
- Neurology
Background:
- Paraffin injections were historically used for cosmetic soft tissue augmentation.
- Long-term complications include paraffinoma formation and chronic inflammation.
- Leprosy can cause peripheral neuropathy leading to muscle atrophy.
Observation:
- A patient with leprosy presented with hypothenar muscle atrophy due to ulnar neuropathy.
- The patient had a 60-year-old paraffin injection for cosmetic purposes, resulting in a paraffinoma and infected skin ulcer.
- The paraffinoma caused disfigurement and recurrent infection.
Findings:
- Surgical excision of the paraffinoma was performed.
- An ulnar artery perforator adiposal flap (140 × 20 mm) was utilized for reconstruction.
- The flap successfully controlled infection and filled the surgical defect.
Implications:
- This case highlights the delayed complications of paraffinoma in leprosy patients.
- Adiposal flap transfer is an effective method for managing complex paraffinomas and associated infections.
- Successful reconstruction restored form and function, improving patient outcomes.
More Related Videos
07:58Stromal Vascular Fraction-enriched Fat Grafting for the Treatment of Symptomatic End-neuromata
Published on: November 23, 2017
10:36Vascularized Composite Hand Allograft Procurement and Preparation for Distal and Proximal Forearm Allotransplantation: A Stepwise Approach
Published on: May 23, 2025