Recurrence rate of basal cell carcinoma in patients submitted to skin flaps or grafts

Abstract: Background: Basal cell carcinoma is the most common type of skin cancer. Although the literature provides a great deal of information on the recurrences of basal cell carcinoma, studies about these indices addressing only the cases in which flaps and/or grafts have been performed for surgical reconstruction of the excision of this tumor are still lacking. Objectives: To evaluate rates of recurrence of basal cell carcinoma submitted to conventional surgery with pre-established margins and reconstruction by flaps or grafts. Methods: A retrospective and observational study was performed through the analysis of 109 patients, who met inclusion criteria with 116 basal cell carcinomas submitted to conventional surgery and pre-established safety margins, requiring reconstruction through a graft or cutaneous flap. This work was performed the small surgeries sector of Dermatology of the Specialty Outpatient Clinic of the University Hospital of the State University of Londrina, between January 1, 2011 and December 31, 2015. The following data were collected and inserted in an Excel worksheet: name, registration number of the hospital patient, sex, age, tumor location, histopathological type of BCC, procedure performed (type of flap and/or graft), follow-up time, recurrence. Results: Of the 116 procedures, there were recurrences in 3 cases (2.6%) that were located in the nasal region and related to sclerodermiform or micronodular histological types. Study limitations: Retrospective nature of the study. Conclusion: The present study of the dermatology department of this university hospital showed a low rate of recurrence of basal cell carcinoma in cases where flaps and/or grafts were used in the surgical reconstruction.

Retalho de interpolação para fechamento de defeito cirúrgico na cauda da hélice da orelha / Interpolation flap for closing a surgical defect in the cauda helicis

A ressecção oncológica auricular pode criar defeitos parciais da pele e/ou da cartilagem que tornam difícil e desafiadora a reconstrução desse local. Várias técnicas têm sido descritas, porém poucos casos de cirurgias para defeitos na cauda da hélice têm sido relatados. Os autores descrevem um retalho de interpolação nessa localização anatômica para correção de defeito secundário à excisão de carcinoma basocelular.

Oncologic ear resection can create partial skin and / or cartilage defects that make reconstruction of this site difficult and challenging. Several techniques have been described, however few cases of surgery for defects in the cauda helicis have been reported. The authors describe an interpolation flap in this anatomical location for the correction of a defect secondary to the excision of a basal cell carcinoma.

Proliferating pilomatricoma - Case report

Proliferating pilomatricoma is proliferative, rare tumor variant of pilomatricoma. It is a benign neoplasm of hair matrix that can have potentially involve local recurrence. We report the case of a 60-year-old man who presented an asymptomatic nodule on the scalp. Histological exam demonstrated a basaloid epithelium at the periphery, filled with eosinophilic cornified material containing shadow cells. The tumor was excised and there was no evidence of recurrence one year later.

Case for diagnosis

Subcutaneous phaeohyphomycosis is an infection caused by dematiaceous fungi which mainly affects immunosuppressed patients. We report a case of subcutaneous phaeohyphomycosis on the back of the left hand in a kidney transplant patient who had been taking prednisone, tacrolimus, and azathioprine daily for 3 years.

Drug-induced acne and rose pearl: similarities / Acne medicamentosa e a perola rosa: semelhancas

Drug-induced acne is a common skin condition whose classic symptoms can be similar to a rose pearl, as in the case of a male patient presenting with this condition after excessive use of a cream containing corticosteroids.

A acne medicamentosa é uma dermatose comum, que pode apresentar no seu quadro clássico semelhanças à pérola rosa, como no caso apresentado de um paciente do sexo masculino cujo quadro surgiu após uso intempestivo de creme contendo corticoesteróide.

American cutaneous leishmaniasis: epidemiological profile of patients treated in Londrina from 1998 to 2009 / Leishmaniose tegumentar americana: perfil epidemiologico dos pacientes atendidos no municipio de Londrina entre 1998 e 2009

BACKGROUND: American cutaneous leishmaniasis is a dermatozoonosis of compulsory notification with relevant morbidity. The disease is considered endemic in northern Paraná. OBJECTIVES: To evaluate the clinical, laboratory and epidemiological aspects of patients with American cutaneous leishmaniasis treated at Clinics Hospital, State University of Londrina, Brazil (Paraná). METHODS: This was an observational, cross-sectional, retrospective and descriptive study. The medical records of patients with American cutaneous leishmaniasis treated at the University Hospital of Londrina - Paraná, from 1998 to 2009 were evaluated. RESULTS: A total of 470 patients, with prevalence of 8.72 cases / 100,000 inhabitants, participated in the study. Most patients were male, aged 21-40 years, with a single ulcerated lesion as the most common clinical presentation, located mainly in an exposed area of the body. With regard to immunological tests, the Montenegro intradermal reaction was positive in 84.4% of cases. Treatment with pentavalent antimony was well tolerated, and patient follow-up for a year occurred in 59% of cases. CONCLUSION: American cutaneous leishmaniasis is still an endemic disease in the region, with a high potential for morbidity, but with a cure rate of around 95% after treatment. The use of immunological techniques facilitates the diagnosis of clinically suspicious cases. .

FUNDAMENTOS: Leishmaniose tegumentar americana é uma dermatozoonose de notificação compulsória com morbidade relevante, considerada endêmica no norte do Paraná. OBJETIVOS: Avaliar os aspectos clinicos, laboratoriais e epidemiológicos de pacientes com leishmaniose tegumentar americana atendidos no Hospital das Clinicas da Universidade Estadual de Londrina, Brasil (Paraná). MÉTODOS: Estudo observacional, transversal, retrospectivo com caráter descritivo. Realizada a avaliação dos prontuários médicos dos pacientes com leishmaniose tegumentar americana atendidos no Hospital Universitário de Londrina - Paraná, no período compreendido entre 1998 e 2009. RESULTADOS: Incluídos no estudo um total de 470 pacientes com uma prevalência de 8,72 casos/ 100.000 habitantes. A maior parte dos pacientes eram do sexo masculino, na faixa etária de 21 a 40 anos, com lesão única ulcerada como apresentação clínica mais comum, com localização principal em área descoberta. Dentre os testes imunológicos, a intradermoreação de Montenegro apresentou positividade em 84,4% dos casos. O tratamento com antimonial pentavalente foi bem tolerado, e o seguimento dos pacientes por um ano ocorreu em 59% dos casos. CONCLUSÃO: Leishmaniose tegumentar americana ainda é uma doença com caráter endêmico na região, com potencial mórbido elevado, porém com percentual de cura com o tratamento usual em torno de 95%. O uso de técnicas imunológicas facilita o diagnóstico de casos clinicamente duvidosos. .

A utilização do retalho AT para reconstrução de ferida operatória no dorso da mão / The use of the AT flap for reconstructing surgical wounds on the dorsum of the hand

O dorso das mãos é sede de tumores que muitas vezes necessitam de abordagem cirúrgica. Devido à limitada mobilidade cutânea, feridas cirúrgicas amplas tornam-se um desafio ao cirurgião dermatológico. Relatamos o caso de paciente apresentando tumor em região dorsal de mão esquerda que, após retirada com margem de segurança, apresentou ferida cirúrgica ampla, tendo sido feita a opção por reconstrução com retalho A-T. Seis meses após, o paciente apresenta-se curado, com preservação total da mobilidade da mão e ótimo resultado estético. Reforça-se o conceito da utilização de retalhos, sempre que possível, para o fechamento de feridas cirúrgicas amplas.

The dorsum of the hand is home to tumors that often require a surgical approach. Due to limited cutaneous mobility, wide surgical wounds become a challenge to dermatologic surgeons. The authors report the case of a patient with a tumor in the dorsal region of the left hand that, after removal with a safety margin, resulted in a wide surgical wound, and in the choice of reconstruction with an A-T flap. Six months later, the patient was cured, with total preservation of the hand's mobility and excellent aesthetic results. The concept of using flaps for closing wide surgical wounds, whenever possible, is reinforced.