Burned-out endemic syphilis (Bejel): facial deformities and defects in Saudi Arabia

Endemic syphilis (bejel) is an endemic, contagious, non-sexually transmitted treponematosis of primitive communities which, if not treated, can cause deformities and defects of the face in its late stage. Several burned-out cases from Saudi Arabia are shown, and the techniques of plastic surgical repair are presented by word and illustrations. We describe in detail a total rhinoplasty (with panfacial reconstruction) in which a scalping flap was used as outer cover and superimposed on a classical island forehead flap based on a subcutaneous pedicle containing both frontal vessels for inner lining.