RESUMEN
BACKGROUND: The incidence of basal cell carcinoma (BCC) in younger individuals has increased in recent decades. However, the characteristics of BCCs in this population, especially in Ibero-Latin American countries, have not been completely defined. OBJECTIVE: To describe the demographic, clinical, and histopathological characteristics of BCCs in patients younger than 40 treated with Mohs Micrographic Surgery (MMS). MATERIALS AND METHODS: A multicenter, retrospective study conducted between January 2009 and December 2014, in five Ibero-American countries, included biopsy-proven BCCs in patients younger than 40 that were treated with MMS. Demographic, clinical, histopathological, and surgical characteristics were described. RESULTS: The study included 301 tumors in 241 patients, of whom 61% were female. The most common Fitzpatrick phototype was III. The most common histological subtypes were nodular (37.5%) and infiltrative (18.9%). Perineural invasion was encountered in 1.7%, and tumor clearance was achieved in 87.4% within two stages of MMS. CONCLUSIONS: This is the first Ibero-Latin American transnational study describing the characteristics of BCCs in young patients treated with MMS. Despite darker skin phototypes in this population, BCCs can occur in early ages and may present with aggressive features. Therefore, MMS may be considered an appropriate first-line treatment option in this population.
Asunto(s)
Carcinoma Basocelular/cirugía , Neoplasias Faciales/cirugía , Cirugía de Mohs , Recurrencia Local de Neoplasia , Neoplasias Cutáneas/cirugía , Adolescente , Adulto , Argentina , Brasil , Carcinoma Basocelular/patología , Carcinoma Basocelular/terapia , Niño , Preescolar , Colombia , Neoplasias Faciales/patología , Neoplasias Faciales/terapia , Femenino , Humanos , Lactante , Recién Nacido , Masculino , México , Invasividad Neoplásica , Recurrencia Local de Neoplasia/patología , Estudios Retrospectivos , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/terapia , Pigmentación de la Piel , España , Adulto JovenRESUMEN
Subungual amelanotic melanoma is rare. In addition, amelanotic melanoma can mimic non-melanocytic tumors. A 67-year-old woman had a four-year history of dystrophy of the left fourth fingernail. Periodic acid-Schiff staining of the nail plate demonstrated fungal hyphae, establishing a diagnosis of tinea unguium. The nail plate subsequently detached and the underlying nail bed showed a red, friable mass that was biopsied and confirmed a diagnosis of melanoma. In conclusion, additional morphologic change of a persistent nail dystrophy-even with a biopsy-confirmed diagnosis of onychomycosis-may require consideration for repeat evaluation, including a biopsy, to exclude the possibility of a subungual malignant tumor.
RESUMEN
BACKGROUND: Postauricular skin is one of the potential donor sites for split-thickness skin grafts (STSGs). OBJECTIVE: To objectively quantify how postauricular donor sites heal after STSG harvesting. MATERIALS AND METHODS: A cohort of 39 Mohs micrographic surgery patients repaired with STSGs (total 41 surgical defects) was established. Scars resulting from postauricular donor site harvesting were objectively quantified by applying the Vancouver Scar Scale (VSS), in which healing of scars is ranked from 0 (best possible outcome) to 13 (worst possible outcome). RESULTS: Vancouver Scar Scale scores were 1.87 for sites followed for ≥6 months (n = 16), 3 for sites followed for 3 to 6 months (n = 7), and 1.61 for sites followed for 6 to 11 weeks (n = 18). Four patients developed mild hypertrophic scarring that resolved spontaneously or with intralesional triamcinolone injections at a concentration of 10 mg/mL. CONCLUSION: The postauricular skin is an excellent donor site for small-to-moderate sized STSGs (<10 cm). The donor sites healed well, as noted by the low scores on the VSS consistent with mild changes in erythema, pigmentation, and texture. The incidence of hypertrophic scarring was low and resolved with observation or treatment.
Asunto(s)
Neoplasias de Cabeza y Cuello/cirugía , Neoplasias Cutáneas/cirugía , Trasplante de Piel , Recolección de Tejidos y Órganos , Sitio Donante de Trasplante , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cirugía de Mohs , Pigmentación , Trasplante de Piel/efectos adversos , Recolección de Tejidos y Órganos/efectos adversos , Torso , Cicatrización de HeridasRESUMEN
A técnica cirúrgica micrográfica de Mohs é modalidade muito útil para excisão de cânceres de pele de difícil manejo. Desde que corretamente realizada, oferece vantagens sobre os outros métodos de tratamento para malignidades cutâneas. O procedimento é dividido em etapas bem definidas: avaliação e marcação da lesão, exérese, preparação e mapeamento da peça cirúrgica, processamento e análise histológica e fechamento da ferida cirúrgica. A avaliação histológica de todas as margens cirúrgicas leva a maiores taxas de cura e maior conservação tecidual, conferindo ao procedimento segurança e confiabilidade.
RESUMEN
A cirurgia micrográfica de Mohs é método amplamente difundido e consagrado nos Estados Unidos, sendo hoje considerado tratamento padrão ouro para diversas situações envolvendo neoplasias cutâneas. Desde a sua primeira descrição pelo Dr. Frederic E. Mohs, a cirurgia micrográfica vem passando por constante processo de modificações e adaptações com o objetivo de desenvolver variações técnicas que melhor se adaptem à rotina diária dos cirurgiões dermatológicos. O presente artigo tem o objetivo de demonstrar as diferentes e inovadoras técnicas em cirurgião micrográfico de Mohs.
http://www.surgicalcosmetic.org.br/public/artigo.aspx?id=119