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Introduction. Wide excision of affected skin tissue and the apocrine glandular region is the standard treatment for advanced HS. Various flap types have been used for coverage. Objective. This study was conducted to assess the use and outcomes of propeller parascapular flaps for unilateral or bilateral axillary defects after excision in patients with advanced axillary HS. Materials and Methods. This retrospective case series reports on 11 patients with unilateral (7 patients) or bilateral (4 patients) advanced HS treated with propeller parascapular flap surgery between July 1, 2016, and December 31, 2018. Flap dimensions were measured. Patients were evaluated in terms of 2 main postoperative complications: postoperative recurrence and flap viability. In addition, other complications such as bleeding, infection, dehiscence, contracture, and hypertrophic scarring were noted. Results. The average flap area was 160 cm2. One flap dehisced; no infection, partial necrosis, or total flap loss occurred, and no recurrence was observed. The mean follow-up period was 18 months. At final follow-up, no patient had contractures that caused restricted movement of the shoulder joint. Conclusion. Parascapular flaps should be the first choice in patients with advanced HS owing to low donor area morbidity, low recurrence rate, wide rotation arc, and sufficient flap size.

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However, I have 3 comments about this article:1. For a hand microsurgeon, it is better to avoid injuring the nailbed by using the Kirschner wire. 2. In the no. 13 reference of the article, Chen et al 2 reported a 100% (7/7) survival rate in Tamai I, and the rate of blood transfusion is 29% (2/7, 1 patient with 3-digit amputation) 3. As mentioned in this article, "These reports suggest that as the tissue volume of the amputated part increases, more effective venous drainage is necessary for the replant to survive.... In contrast, as the tissue volume of the amputated part decreases, the survival rate of the replant increases, even under poor venous drainage conditions." 1 The bony shortening and excision of the soft tissue distal to fingerprint core made the subzone III and IV shifting to the subzone of II. So, the title should be "Ishikawa II replantation using artery-only anastomosis with a pulp tissue reduction method." For example, in the case 2, fusion of interphalangeal joint and excision of the distal tissue made the amputation level from IV to near II. The successful rate of replantation without venous anastomosis increased.

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Introduction: Toxic epidermal necrolysis is a severe, acute, mucocutaneous, life-threatening hypersensitivity syndrome with high mortality and bullous lesions on the skin, eyes and mucous membranes. It often develops due to drugs. Sulfonamide group antibiotics and antiepileptic drugs are the most commonly responsible agents. Allopurinol is a common cause of toxic epidermal necrolysis as in most drug reactions. Colchicine is widely used in dermatology and rheumatology and is generally known as an agent with a broad safety profile.Case report: Here we present a case of toxic epidermal necrolysis in our case with allopurinol, colchicine and alcohol use in order to draw attention to the increased risk of drug coexistence. Conclusion:Again, we wanted to draw attention to the management of our case and the efficacy and safety of high-dose intravenous immunoglobulin therapy.