ABSTRACT
BACKGROUND: Skin tumors surgery is common and well established. There is discrepancy between recommendations on macroscopic margins to apply and therapeutic decisions taken on histological margins. The purpose of this study is to examine skin shrinkage upon exeresis, then in formalin, to understand the anatomo-clinical discrepancy, which is often found. MATERIAL AND METHODS: It was a prospective study, lasting a month, including patients receiving skin surgery. For each tumor, the surgeon carried out 4 margins measurements before and after exeresis ; margins measured again in histology. The evaluation criterion was the difference between preoperative, postoperative and histological margins measurement. These data was weighting according to factors linked to the patient and the tumor. RESULTS: Seventy-nine tumors for 61 patients had been studied. The study showed a significant shrinkage between preoperative measurements and postoperative, from 0.4 to 0.6mm. It is correlated with no one tested factors. Significant shrinkage between 0.4 and 0.5mm was also established between preoperative and histological measurements. However, there is a significant augmentation between postoperative and histological measurements. CONCLUSION: This last result could be linked to the inflammatory peri-wound skin that surgeon consider as tumoral process so exclude of his margin, while histology could show a healthy area. In front of these results, an expert committee leading a more important study could include histological margins recommendations to the actual clinical recommendations.
Subject(s)
Carcinoma, Basal Cell/surgery , Margins of Excision , Skin Neoplasms/surgery , Skin/pathology , Age Factors , Aged , Body Mass Index , Carcinoma, Basal Cell/pathology , Dermatologic Surgical Procedures , Female , Humans , Male , Postoperative Period , Prospective Studies , Sex Factors , Skin Neoplasms/pathology , SmokingABSTRACT
The authors report two cases of acute suppurative lesions due to Actinomyces odontolyticus. They point out the fairly high incidence of this pathogen in such conditions, either isolated or more often as part of a mixed flora. Conversely, Actinomyces odontolyticus is only exceptionally recovered in true actinomycosis.