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Peri-operative view of initial resection (published with the patient's consent).
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The woman was admitted and underwent immediate widespread local excision of necrotic tissue extending from and including the left lower eyelid, left cheek and the soft tissues overlying the left angle of mandible and lateral aspect of upper neck (Fig. 1).
Immediate post-operative view of secondary resection (published with the patient's consent).
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After close liaison with several senior colleagues, the patient underwent further surgical excision of necrotic tissue affecting the left forehead, left temporal region, left upper eyelid and left commissure with concomitant exenteration of left orbital contents (Fig. 2). 