Pilomatrixoma: A Clinico - Pathological Study

Introduction: Pilomatrixoma (calcifying epithelioma ofMalherbe) is a benign skin tumor with differentiation towardshair follicles. Pilomatrixoma may be mistaken for many otherconditions like epidermoid cyst, dermoid cyst, calcified lymphnode or a hemiangioma. The aim of this study was to describethe clinical and histopathological characteristics of patientspresenting with pilomatrixoma.Material and Methods: The present study was conductedin the Post Graduate department of pathology, govt. medicalcollege Srinagar. 51 cases of pilomatrixoma were included inthe study. The final diagnosis was arrived by histopathologicalexamination of the specimens. The clinical features andphysical examination including age, sex, site of lesion andsize were noted and analyzed.Results: 51 cases of pilomatrixoma, comprising about 37%cases of all skin adnexal tumors were considered. The mostcommon age group involved was 11-20 years comprising of33.34% of all cases. 23 (45.10%) were males and 28 (54.90%)were females. There was a slight female predominance. Themost common anatomical location for the tumor was foundto be head and neck followed by trunk, upper limbs and lowerlimbs. The histopathological findings observed were: a benignwell demarcated lesion surrounded by a capsule in almost allof the cases. The lesions were found to be composed of islandsof epithelial cells embedded in a stroma. Two types of cellswere identified in these epithelial islands basaloid cells andshadow cells.Conclusions: Pilomatrixoma should be considered in thedifferential diagnosis of nodules, especially those on the headand neck. Careful clinical examination and familiarity withthe condition may lead to accurate diagnosis and appropriatetreatment.

A Retrospective Study of Skin Tumor of the Nose according to Its Anatomical Location / 대한피부과학회지

BACKGROUND: The nose plays an important aesthetic, functional role and is located at the center of the face. Due to the characteristics of its anatomical location, the nose is easily exposed and damaged due to weathering, trauma, and inflammation. OBJECTIVE: This study aimed to provide information on the most common benign and malignant tumors according to their location on the nose. METHODS: A retrospective study was conducted on 217 patients who visited the Department of Dermatology at Chosun University Hospital and underwent biopsy for suspected skin tumors in the past 6 years. The tumor was classified as benign, pre-cancerous, and malignant. Differences in the distribution of the anatomical locations of each disease group were analyzed according to the eight anatomical locations of the nose. RESULTS: Based on the external nose anatomy, the most common site where skin tumors usually occurred was the nasal alar (29%), followed by the nasal dorsum and nasal sidewall (23.5% and 20.2%, respectively). The most common skin tumor was malignant tumor (72.3%), followed by benign tumor (21.1%) and premalignant disease (6.4%). CONCLUSION: I In this study, among patients who underwent biopsy for suspected tumor in the nose, the most common neoplasm was malignant skin tumor and the most common anatomical location was the nasal alar. Therefore, a rapid diagnosis and treatment of skin tumors that occur in the nasal alar wound be necessary.

Tumor triquilemal proliferante: reporte de un caso y revisión de la literatura / Trichilemmal proliferating tumor: case report and literature review

RESUMEN El tumor triquilemal proliferante es una neoplasia poco frecuente, usualmente sólida o parcialmente quística que se origina de la vaina externa de la raíz de un folículo piloso. Ocurre principalmente como una lesión solitaria en el cuero cabelludo de mujeres mayores. Presentamos el caso de una mujer de 56 años con un tumor cervical de nueve años de evolución. El estudio de la pieza de resección confirmó el diagnóstico.

ABSTRACT Trichilemmal proliferating tumor is an infrequent neoplasia, usually solid or partially cystic, originating in the external root sheath of hair follicle. It occurs mainly as a solitary lesion in the scalp in older women. We report the case of a 56 years old woman with a cervical tumor of nine years of growth. Histology of the resection specimen confirmed the diagnosis.

Recurrent Indeterminate Dendritic Cell Tumor of the Skin

Indeterminate dendritic cell tumor (IDCT) is a dendritic cell tumor that displays histologic features similar to those of Langerhans cells. The origin of the indeterminate cells may represent precursors of Langerhans cells or skin dendritic cells. IDCT is extremely rare, and tumor progression and predictive factors are not well known. Here, we report a case of a 61-year-old man who presented with a papule on his back and was finally diagnosed with IDCT based on histology and immunohistochemistry. The tumor recurred three months after surgical excision.

A case of nasal NK/T-cell lymphoma / 中南大学学报(医学版)

A 29-year-old male patient with extranodal NK/T-cell lymphoma,a nasal type lymphoma with involvement of skin as the first symptom,was reported.The patient presented with swelling in the left side of the nose and suffered intermittent fever for 1 month.The fester in the oral mucosa and skin under the left nostril and redness,and the swelling on the orbit of the left eye lasted for 1 week.Physical examination showed that the left side of nose was swelling,and the skin below the left nostril was anabrotic and crusted.There were different ulcers in his jaws and buccal mucosa.Bilateral eyelid was redness and swelling,especially in the left side.Binocular conjunctival was congestive.The diagnosis of extranodal NK/T-cell lymphoma (nasal type) was confirmed by biopsy and immunohistochemistry.

Simultaneous Development of Three Different Neoplasms of Trichilemmoma, Desmoplastic Trichilemmoma and Basal Cell Carcinoma Arising from Nevus Sebaceus

Nevus sebaceus is a hamartoma of the sebaceous gland that occurs congenitally, from which various secondary tumors can arise with a prevalence of 5%–6%. Benign neoplasms commonly arise from nevus sebaceous, but they have a very low malignant potential. Two neoplasms may occasionally arise within the same lesion, but it is rare for three or more neoplasms to occur in a nevus sebaceus simultaneously. A 61-year-old male patient was admitted to our hospital for a 4 cm×2.5 cm growing tumor in a verrucous form arising within a periauricular nevus sebaceus in the post auricle of the left ear that had developed 30 years earlier. The nodule was diagnosed as 3 different types of tumors: trichilemmoma, desmoplastic trichilemmoma, and basal cell carcinoma. To our knowledge, this is the first report of the coexistence of three different tumors arising from nevus sebaceous. It contain malignant neoplasm also. Surgeons should be aware of the need for close monitoring and early complete surgical excision of sebaceous nevus in order to improve patient outcomes.

Pilomatricoma como diagnóstico diferencial de adenitis cervical granulomatosa

El niño con una masa cervical representa un desafío para el pediatra. Lo más frecuente en niños son los procesos benignos de origen infeccioso. Presentamos un niño con tumoración laterocervical posterior con diagnóstico de pilomatricoma, tumor benigno poco conocido en Pediatría . No presenta características específicas, por lo que su diagnóstico se base en el estudio de anatomía patológica. El único tratamiento posible es la exéresis completa. El pilomatricoma se debe incluir en el diagnóstico diferencial de adenitis cervical en niños para evitar intervenciones y tratamientos innecesarios.

Children with neck masses are an everyday challenge for pediatricians. Infectious diseases are the most common etiology in childhood. We report a child with a neck mass who was diagnosed with pilomatrixoma. It is a quite unknown benign skin tumor in pediatrics. It cannot be easily differentiated from other skin tumors, and biopsy is necessary to make the definitive diagnosis. Treatment of pilomatrixoma consists of total surgical excision. Pilomatrixoma should be considered in the differential diagnosis of cervical lymphadenitis in children to avoid unnecessary interventions and antibiotic treatment.

Tumores da mão parte III: tumores de pele da mão / Tumors of the hand, Part III: Skin tumors of the hand

O tumor de pele da mão corresponde ao câncer primário mais comum dessa região. Apesar de proporcionalmente cobrir uma pequena superfície do corpo, corresponde a uma parte considerável de todos os tumores de pele. O objetivo principal deste trabalho é mostrar de forma simples e clara as lesões mais prevalentes e encontradas no ambulatório médico, de uma forma que este pode ser usado para consulta e orientação do profi ssional médico das mais diversas especialidades, objetivando um diagnóstico rápido e assertivo, que interferirá positivamente no desfecho da doença. Nesta terceira parte do trabalho são abordados fundamentos, conceitos, classifi cações e abordagens para o melhor prognóstico do paciente.

Skin tumor of the hand is the most common primary cancer of this region. Although covering a proportionally small surface of the body, it accounts for a substantial part of all skin tumors. The main aim of this work is to show simply and clearly the most prevalent injuries found in the outpatient clinic, so that it can be used by healthcare providers from various specialties as a consultation and guidance resource, aiming at a quick and assertive diagnosis that will interfere positively with disease outcome. This third part of the work covers the fundamentals, concepts, classifi cations and approaches for a better prognosis.

Simple Excision for Skin Tumor without Diagnostic Evaluation: What Are the Problems If It Is Malignant? / 대한피부과학회지

BACKGROUND: Although some skin tumors possess distinct clinical features, biopsy is essential to confirm diagnosis in most cases of skin tumor. Furthermore, the appropriate treatment method is determined according to the diagnosis. Clinicians experience difficulties in further evaluation and management of patients who present after simple excision of skin tumor before definite diagnosis. OBJECTIVE: To evaluate the characteristics of simply excised malignant skin tumor before confirming the diagnosis. METHODS: A retrospective study was conducted by reviewing the records of patients who presented after excision of malignant skin tumor without confirming diagnosis in other hospitals. We investigated the initial and final diagnosis, completeness of excision, recurrence, and management. RESULTS: Thirty-one patients were enrolled in this study. Most patients had undergone an operation by a surgeon. Although basal cell carcinoma and squamous cell carcinoma were common, various other tumors including myxofibrosarcoma, mucinous eccrine carcinoma, sebaceous carcinoma, and porocarcinoma, were also found. Re-operation was required in most cases. CONCLUSION: Our study showed that excision of malignant skin tumor before definite diagnosis leads to many problems, such as the delay of accurate diagnosis, possibility of incomplete excision, and difficulty in localizing the remaining tumor and deciding the resection margin.

Xantogranulomatosis juvenil diseminada: A propósito de un caso / Juvenile disseminated xantogranuloma: A case report

Se presenta una femenina de dos años y tres meses de vida, con dermatosis congénita diseminada, caracterizada por varias tumoraciones sésiles bien definidas, mayores de 1-2 cm de tamaño, duras al tacto, compatibles con xantogranuloma múltiple sin involucro patológico interno.

A female of two years-old with congenital disseminated dermatosis, characterized by several distinct sessile and firm tumors larger than 1-2 cm, was compatible with multiple xanthogranuloma, no internal disease appears get involved.

Caracterização molecular de DNA de Delta papillomavirus bovino (BPV1, 2 e 13) em sarcoides equinos / Molecular characterization of bovine Deltapapillomavirus (BPV1, 2, and 13) DNA in equine sarcoids

Sarcoides são tumores fibroblásticos, considerados os tumores de pele mais comuns em pele de equinos e que raramente apresentam regressão espontânea. Papilomavírus bovino (BPV) tipos 1 e 2 são relacionados com a patogenia do sarcoide e, provavelmente, o BPV tipo 13 (BPV13), recentemente descrito, também pode estar associado com a formação dessa lesão. Neste estudo, 20 amostras de lesões cutâneas, sendo 12 constituídas por tecidos frescos e 8 amostras de tecido fixado em formalina e embebido em parafina, provenientes de 15 cavalos foram utilizadas para a identificação do DNA de BPV. A análise histopatológica (HE) confirmou todas as lesões como sarcoide. Para a amplificação do DNA de papilomavírus (PV) foram realizadas três reações de PCR. Como triagem, os primers IFNR2/IDNT2 foram utilizados para amplificar um fragmento da ORF L1 do PV. O segundo par de primersutilizado é complementar a sequência dos genes E5 e L2 de BPVs 1, 2 e 13. O terceiro par de primers(FAP59/FAP64) utilizado tem o gene L1 como alvo. A primeira e a segunda PCRs permitiram amplificar produtos em todas as amostras avaliadas. Entretanto, na terceira reação, na qual foram utilizados os primers FAP, foi possível amplificar produtos com tamanho molecular esperado somente nas amostras constituídas por tecidos frescos. O sequenciamento de nucleotídeos e as análises filogenéticas realizadas nos fragmentos E5L2 resultaram na identificação de BPV1, 2 e 13 em 14 (70%), 2 (10%) e em 4 (20%) amostras de sarcoides, respectivamente. As amostras de sarcoides de um dos animais continha somente o DNA de BPV1. Entretanto, nas amostras provenientes do segundo cavalo foi possível identificar o DNA de três tipos de Deltapapillomavirus bovino (BPV1, 2 e 13) em lesões distintas. Este estudo ratifica a presença do DNA de BPV1, 2 e 13 em lesões de sarcoides em equinos, além de identificar três tipos de BPVs em um mesmo animal e descrever pela primeira vez no Brasil a presença de BPV1 e 2 nesse tipo de lesão.

Sarcoids are fibroblastic lesions, which are considered as the most common skin tumors of horses; spontaneous regression rarely occurs. The bovine papillomavirus (BPV) types 1 and 2 may be involved in the pathogenesis of sarcoids, and probably the recently described BPV type (BPV13) might be associated with the pathogenesis of this lesion. This study characterized the DNA of BPVs in sarcoids from 15 horses from Brazil by analyzing 20 cutaneous lesions (12 recently collected; 8 from formalin-fixed paraffin-embedded (FFPE) tissues). Histopathology confirmed the proliferative lesions as sarcoids. Three PCRs were performed to amplify papillomavirus (PV) DNA. For screening, the primers IFNR2/IDNT2 were used to amplify a fragment of the PV L1 ORF. The second primer set was complementary to a common sequence of the E5L2 genomic region of BPV1, 2, and 13. The third primer pair (FAP59/FAP64) targeted a fragment of the PVs L1 ORF. The screening and E5L2 PCRs yielded amplicons in all samples evaluated. The FAP amplicons identified BPV1, 2, and 13 only from fresh tissue samples. The phylogenetic analyses of E5L2 resulted in the identification of BPV1, 2, and 13 in 14 (70%), 2 (10%), and 4 (20%) sarcoids, respectively. Two horses demonstrated multiple lesions: the sarcoids of one of these contained only BPV1 DNA and those of the other contained three types of bovine Deltapapillomavirus (BPV1, 2, and 13). This study confirmed the presence of BPV1, 2, and 13 DNA in equine sarcoids. Moreover, these findings represent the first description of three types of BPV diagnosed in the same horse, as well as the first confirmation of BPV1 and 2 in horses from Brazil.

A Clinical Analysis of Skin Disease among the Elderly in the Western Gyeongnam Province / 대한피부과학회지

BACKGROUND: With the advancement of socioeconomic and medical sciences, the number of elderly patients with skin diseases significantly increased. Therefore, the epidemiologic survey of dermatologic disease is in need for the elderly population. OBJECTIVE: The purpose of this study was to evaluate the prevalence of dermatologic diseases in elderly patients and to compare the results with the previous reports in malignant and benign skin tumors. METHODS: We retrospectively reviewed the clinical records of 2,678 outpatients older than 65 years of age, who visited the Department of Dermatology from January 2010 to December 2013. We compared the clinical diagnoses and analyzed the distribution of dermatologic diseases and clinical features, including the factors of age and sex. Among them, 575 patients who received biopsy for skin tumors were pathologically analyzed, confirmed, and classified as malignant or benign tumor. RESULTS: The incidence of skin disease in the group of patients older than 65 years of age was 15.6% (2,678). The ratio of men to women was 1 : 1.13 (1,257 : 1,421). The types of skin diseases in the group were as follows: infectious skin disease (26.1%); eczema (23.2%); epidermal and adnexal nevi and tumors (17.5%); drug eruption, erythema, and urticaria (7.0%); pruritus, psychocutaneous disorder, and neurocutaneous dermatoses (6.6%); papulosquamous disease (3.3%); diseases of the skin appendages (3.2%); disorders of pigmentation (2.5%); diseases of the mucous membrane (2.3%); cutaneous vascular diseases (2.2%); and skin tumors (21.5%). The most common malignant tumors were as follows: squamous cell carcinoma (33.9%), basal cell carcinoma (31.2%), Bowen's disease (19.0%), keratoacanthoma (7.2%), malignant melanoma (5.0%), and lymphoma (1.8%). The most common benign tumors were as follows: actinic keratosis (48.0%), seborrheic keratosis (17.2%), epidermal cyst (12.7%), melanocytic nevus (6.2%), hemangioma (3.7%), milia (2.0%), and hypertrophic scar and keloid (2.0%). The incidence of malignant tumors in women was much higher than in men, with a ratio of 1 : 1.96. CONCLUSION: This study provides useful data on the incidence and the characteristics of elderly skin diseases. Compared to the previous studies, the frequency of malignant tumors was relatively higher and variable. We advise physicians to make the appropriate diagnosis and treatment for the early detection of skin tumor, especially the squamous cell carcinoma and basal cell carcinoma, which are caused by long-term exposure to the sun.

Dermatoscopía del poroma ecrino: a propósito de un caso clínico / Dermoscopy of eccrine poroma: a case report

El poroma ecrino es un tumor benigno anexial raro. Clínicamente se presenta como un nódulo solitario rosado, asintomático, topografiado comúnmente en palmas y plantas. El diagnóstico clínico diferencial más importante se plantea con el melanoma amelanótico. La dermatoscopía ayuda en algunos casos a distinguir entre ellos. Se describe el caso de una paciente de 50 años que se presenta con un nódulo palmar derecho que a la dermatoscopia presenta estructuras vasculares solitarias, glomerulares, con áreas blanco rosadas sin estructuras y pequeñas erosiones. El diagnóstico histopatológico fue de poroma ecrino.

Eccrine poroma is a rare benign adnexal tumor. It usually, presents as an asymptomatic, solitary, pink nodule in palms and soles. Its main differencial diagnosis is amelanotic melanoma. Dermoscopy can improve the differentiation between them. We describe the case of a 50 year-old woman who presented with a nodule in the her right palm which at dermoscopy showed solitary vascular structures, glomerular vessels, pink white structureless areas and little erosions. The histopathologic diagnosis was eccrine poroma.

Pilomatrixoma: una presentación clínica inusual / Pilomatrixoma: unusual clinical presentation

El pilomatrixoma, una neoplasia benigna poco frecuente, se origina de la matriz del folículo piloso. Es más frecuente durante la infancia, especialmente entre los 5 y 15 años de edad. La forma múltiple de pilomatrixoma es rara y su presencia se asocia a síndromes sistémicos, entre los cuales destaca la distrofa miotónica. El diagnóstico de pilomatrixoma es fundamentalmente clínico. Estudios complementarios como la ecografía pueden ser útiles para confrmar su diagnóstico. La resección quirúrgica de la lesión corresponde el tratamiento curativo, con baja tasa de recurrencia. Se presenta una paciente de sexo femenino, de 17 años de edad, por su pilomatrixoma de características clínicas inusuales en edad pediátrica: variante anetodérmica, forma múltiple y crecimiento rápido.

Pilomatrixoma is a rare, benign neoplasm that is derived from hair matrix cells. It is more frequent during childhood, especially between the ages of 5 and 15 years. Pilomatrixoma is usually a hard, well circumscribed, solitary lesion, and can be located on any part of the body, except palms and soles, with a predilection for maxilofacial region. Multiple pilomatrixomas are rare and they have been associated with various systemic syndromes, of which myotonic dystrophy has been the most described. The diagnosis of pilomatrixoma is fundamentally clinical. Complementary studies such as ultrasound can be useful to confrm the diagnosis. Excisional surgery is the standard curative treatment. We present a 17-year-old female patient with an extremely uncommon clinical presentation of pilomatrixoma: multiple lesions, anetodermic, and rapid growth.

A case of metastatic skin tumor treated with Mohs' gauze methods using gauze applied with Mohs' paste

Mohs' paste is a histopathological fixative with zinc chloride as the main ingredient. It has been applied to perform chemosurgery of skin tumors. In recent years, this paste has been reportedly very effective for control of various symptoms of skin metastasis in inoperable advanced cancer, such as pungent odor and hemorrhage in the field of palliative care. Shigeyama et al. modified the composition of the original Mohs' paste in order to regulate its viscosity; they added glycerin to a mixture of zinc chloride and zinc oxide. However, there may be difficulty in pasting this agent to a target region, because of its very high viscosity. Therefore, we devised two methods to overcome this difficulty; one was to paint the surface of a small piece of gauze with Mohs' paste, and the other was to apply the paste directly on the gauze and apply it to a lesion. We called the above two modifications, "Mohs' gauze method A and B." Mohs' gauze was used for the treatment of hemorrhage, pungent odor and huge exudate from a metastatic skin tumor of gastric cancer. These conditions disappeared without any side effects. We did not recognize the difference in fixation effect of the lesion between the conventional Mohs' paste method and our Mohs' gauze methods. Our method should make the Mohs' paste easier to apply, and might extend its indication. Palliat Care Res 2011; 6(1): 324-329

Cosmetic efficacy of topical 5-aminolaevulinic acid-photodynamic therapy on cephalic and facial skin tumors / 中华医学美学美容杂志

Objective To investigate and summarize the clinieal effects and cosmetic results of 5-aminolaevulinic acid-photodynamic therapy (ALA-PDT) on cephalic and facial skin tumors.Methods Patientswith skin basal eell carcinoma(BCC),squamous cell carcinoma (SCC),keratosis seborrheica (KS),and solar keratosis (SK) were included in this study.Inoperable cases were given topical ALAPDT,and received clinical response evaluation and satisfying questionnaire after 3 months follow-up.Resalts28 patients including 16 BCCs,8 SCCs,2 KSs and 2 SKs received ALA-PDT.100% BCC had responseto PDT,including 15 cases with complete response (CR);only one recurred.Overall response rate was 67% for SCC,2 of 8 cases failed to continue the treatment,3 eases CR,1 case partial response (PR) and 1 patient with no response.Response rate was 0% in KS.100% of SK had response to PDT,and 2 cases showed CR and PR,respectively.64.2% patients (18/28) showed extreme satisfaction for cosmetic outcome,11% (3 cases) satisfaction,7.1% (2 cases) little satisfaction,and 10.7% (3 cases) no satisfaction.Conclusion Topical ALA-PDT is an effective and satisfied treatment with lower recurrent rates, especially for cephalic and facial skin tumors including BCC,SCC and SK,but no response for KS.

Pilomatrixoma in a Maltese Dog / 한국실험동물학회지

A 12-year-old female Maltese dog brought to a local veterinary clinic with two nodules in the subcutis of left shoulder. The nodules were grown gradually from 2 years ago. The nodules were removed surgically under anesthesia and examined histopathologically. They were 15x26 mm in diameter (oval form) and 12x15 mm in diameter (round form), respectively. Histopathologically, the lesions consisted of multilayered basaloid cells in the peripheral of the mass and ghost cells in the central region. Typical findings of these two nodules were gradually keratinized basaloid cell toward central area result in forming anuclear ghost cells. These microscopic features of cutaneous nodules were diagnosed as pilomatrixoma and the identified findings were similar to fully developed stage of human pilomatrixoma. This report may assist in the categorizing of canine pilomatrixoma using histopathological features.

Prevalence of Foxp3 Positive T Regulatory Cells is Increased during Progression of Cutaneous Squamous Tumors

PURPOSE: Forkhead box p3 (Foxp3) positive T regulatory cells (Tregs) have a functionally immunosuppressive property that prevents effector cells from acting against self in autoimmune diseases or a tumor. It is known that Tregs may be highly relevant in cancer progression. Dendritic cells (DCs) induce cutaneous immune response, however several studies have suggested that DCs are involved in immunosuppression. The aim of this study is to evaluate the prevalence of Tregs and DCs infiltration in cutaneous premalignant and malignant squamous lesions. MATERIALS AND METHODS: We evaluated Tregs and DCs in skin tissue samples obtained from 83 patients with actinic keratosis, Bowen's disease or squamous cell carcinoma by immunohistochemistry. RESULTS: The prevalence of Tregs and DCs was significantly higher in squamous cell carcinoma and Bowen's disease than in actinic keratosis. In addition, the number of DCs was closely correlated with the prevalence of Tregs, and DCs were also located in direct proximity to Tregs. CONCLUSION: Tregs is related to cutaneous squamous tumor progression.

Clinical application of ultrasound in dermatological cases.

Ultrasonography has been recognized as an important diagnostic modality in medicine and has entered the area of clinical dermatology. Its non-invasive characteristics have made it easily use and completely safe. It provides important diagnostic information in evaluating skin tumors. It also outlines the subcutaneous lesions and their relation to its adjacent tissue. Another ultrasound technique is color Doppler which is useful to assess vascularization of skin lesion. In this article, we would like to report ultrasound imaging in some selected cases from our institution.

Removal Skin Tumors of 4 Cases by Using the Modified S-plasty / 대한피부과학회지

Conventional S-plasty is a modified method showing favorable results compared with the standard fusiform excision. The modified S-plasty can greatly reduce the tension of suture lines as well as the length of the suture by approximately two thirds. It therefore obtains excellent aesthetic outcomes. So far, skin grafts or flaps have been used as a general method when a simple primary closure is impossible, but these are complex and take much time. In this case, we can get better surgical and aesthetic results by using the modified S-plasty instead. The scar is more natural if a curved line is sutured along the skin crease of the forehead or nasal area on the face. We surgically removed skin tumors in 4 cases by using the modified S-plasty. All resulted in good aesthetic outcomes.