RESUMO
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.
RESUMO
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.
Assuntos
Neoplasias de Cabeça e Pescoço/cirurgia , Neoplasias Cutâneas/cirurgia , Transplante de Pele , Coleta de Tecidos e Órgãos , Sítio Doador de Transplante , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cirurgia de Mohs , Pigmentação , Transplante de Pele/efeitos adversos , Coleta de Tecidos e Órgãos/efeitos adversos , Tronco , CicatrizaçãoRESUMO
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