Auto-Mohs.com.

BACKGROUND: Over the course of the last three decades Americans have grown more and more fond of "alternative" or homeopathic medical therapies. The explosion of the Internet has made these nontraditional remedies more accessible to the general public. OBJECTIVE: To describe two cases of auto-Mohs through patient self-application of products containing zinc chloride paste. The case of a basal cell carcinoma and the case of a squamous cell carcinoma are described. METHODS: Each of our patients applied a homeopathic paste containing zinc chloride to sites of biopsy-proven skin cancer. RESULTS: At the conclusion of the self-directed therapy in both cases, histopathologic analysis of the site determined no further skin cancer to be present. CONCLUSION: We present and describe two cases of auto-Mohs.

Metastatic microcystic adnexal carcinoma in an immunocompromised patient.

BACKGROUND: Microcystic adnexal carcinoma is an uncommon, locally aggressive cutaneous neoplasm. To date, there are only two reports of histologically proven lymph node involvement with this tumor. We describe a case of a patient with microcystic adnexal carcinoma who developed multiple local metastasis in transit with histologically proven lymph node involvement and was diagnosed with chronic lymphocytic leukemia. OBJECTIVE: To describe the details of our case and to review what is currently known about this tumor. METHODS: Mohs micrographic surgery was utilized for tumor removal. RESULTS: This patient developed multiple tumors of the scalp over the period of a 1 year which were histologically proven to be microcystic adnexal carcinoma. All tumors were noncontiguous and presented on the scalp. During the histologic analysis of the last tumor removed by Mohs micrographic surgery a lymph node was resected which revealed infiltrative microcystic adnexal carcinoma. CONCLUSIONS: We present the case of an immunocompromised patient treated for microcystic adnexal carcinoma with Mohs micrographic surgery who proceeded to develop local metastasis in transit.

The use of a digital imaging system in a dermatologic surgery practice.

BACKGROUND: Digital imaging systems are now commercially available, reasonably affordable, and much improved in quality. OBJECTIVE: To present our 2-year experience with a digital imaging system in Mohs and dermatologic surgery practice and to inform readers of the equipment needed, its cost, uses, advantages, and disadvantages compared with conventional photography. CONCLUSION: The advantages of a digital imaging system include quality images, easy storage and retrieval, and cost-effectiveness. The disadvantages are few: a substantial initial investment and the training of office personnel in its use and maintenance. Uses include monitoring nevomelanocytic lesions, surgical photo documentation, medical records, and a photographic research database.

Postoperative techniques for corneal protection in Mohs micrographic surgery.

Corneal abrasion or injury can complicate periorbital surgery. In micrographic surgery of the eyelids and canthal regions, enough palpebral tissue may be sacrificed so that corneal exposure and injury can occur. In the interim between surgery and reconstruction, adequate measures must be taken to ensure protection of the globe. Techniques that protect the corneal epithelium for small or large surgical defects are described.

Lateral nose and perinasal defects: options in management following Mohs micrographic surgery for cutaneous carcinoma.

Primary and recurrent cutaneous carcinomas of the nose and the adjacent perinasal tissues often invade more deeply than cutaneous carcinomas in other areas. The operative defect may be large. The physician who has to close these defects is faced with a challenging problem that requires an appreciation of facial anatomy and function. There is often more than one option in the repair of these defects. Important concepts in the management of lateral nose and perinasal surgical defects are discussed.

Basal cell carcinoma arising in a sebaceous nevus during childhood.

It is uncommon for malignancy to develop in a sebaceous nevus before puberty. We report a case of basal cell carcinoma arising in a sebaceous nevus during childhood in a normal-appearing lesion. Periodic evaluation to detect malignant degeneration is recommended for children even if removal is encouraged at a future date.

Cutaneous complications of heart transplantation.

Since July 1984, 12 heart transplants have been performed at the University of Kansas Medical Center During this period, all recipients were screened for any dermatologic problems that may have been present, either before surgery or that may have resulted postoperatively as a consequence of immunotherapy used to suppress heart rejection. This report describes the most common cutaneous findings that in our experience include hypertrichosis, herpes simplex, warts, tinea, and steroid acne. Although these are usually not life-threatening problems, careful attention to the skin and mucous membranes may prevent serious infectious complications, improve personal hygiene, and bolster the patient's self-image.