Trichoblastoma is a slow-growing and well-circumscribed rare adnexal tumor. Although considered a benign neoplasm, there are cases of aggressive trichoblastomas. This paper reports a case of a 66-year-old female patient with a recurrent and continuously growing tumor in the right nasal wing that was treated with Mohs Micrographic Surgery.

Keywords: MOHS SURGERY, SKIN NEOPLASMS, SURGICAL FLAPS

Introduction: Cutaneous melanoma has significant relevance among malignant skin tumors, for despite its low incidence (3-4%) it is associated with the highest mortality. In Brazil, estimates for the year 2014 correspond to 10% of all cancers, establishing this as an important public health issue. Objectives: To present epidemiological data related to melanoma skin cancer in the midlands of the Brazilian State of São Paulo. Methods: Descriptive retrospective cross-sectional analysis of data from a tertiary hospital's medical records. The analysis was subject to measurement and information bias. A descriptive analysis with frequency and percentage was carried out. Results: There was a prevalence of cutaneous melanoma in women (71%), patients between 50 and 70 years of age (56%), Caucasians (78%), and individuals who identified their lesions through self-examination (42%), with predominant involvement of the trunk (35%). The most prevalent histological subtype was the superficial spreading (58%). Conclusions: Understanding the epidemiology of cutaneous melanoma in a given geographic region enables and facilitates medical actions, allowing for the better establishment of strategies for primary and secondary prevention.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

Introduction: In the dermatologic surgery practice, Mohs micrographic surgery is of great value in the excision of cutaneous neoplasias. Nevertheless, in certain types of neoplasia, immunohistochemistry can increase diagnostic accuracy.
Objective: To describe the use of Mohs micrographic surgery associated to immunohistochemistry and evaluate their effectiveness regarding traditional methods.
Method: Mohs micrographic surgery was performed in 5 cases of diverse cutaneous neoplasias. Tissue evaluation with hematoxylin-eosin and immunohistochemistry were carried out intraoperatively.
Results: There was greater prevalence of elderly female patients with higher frequency of recurred basal cell carcinomas in the face. In all cases it was possible to perform immunohistochemistry in the frozen specimen. In most cases, primary closure was carried out in the first stage of the Mohs surgery, without postoperative complications.
Conclusion: The combination of the two techniques can increase the procedure's sensitivity, guaranteeing the presence of free margins, leading to fewer recurrences and allowing the preservation of a greater amount of neoplasia-free tissue.

Keywords: MOHS SURGERY, IMMUNOHISTOCHEMISTRY, SKIN NEOPLASMS

The Merkel cell carcinoma is a rare tumor of neuroendocrine and epidermal origin and with poor prognosis. It is classically associated with immunosuppression, exposure to the sunlight and, more recently, with the polyomavirus. It is positive for epithelial and neuroendocrine markers. The combined expression of these markers confirms the diagnosis. Polyomavirus tumors have an unfavorable prognosis. The authors report a case of Merkel cell carcinoma with atypical immunophenotype (CK20 negative) and aggressive behavior. The present report is aimed at highlighting the importance of dermatologists having knowledge of different immunophenotypes that may be associated with the Merkel cell carcinoma.

Keywords: CARCINOMA, MERKEL CELL; IMMUNOHISTOCHEMISTRY; MERKEL CELL POLYOMAVIRUS

Lower lip squamous cell carcinomas (SCC) correspond to 20-30% of all oral cavity cancers. It mainly affects men over 50 years of age who have previous history of smoking, alcoholism and exposure to the sunlight. The diagnosis is clinical, confirmed by histological analysis. The present paper describes a case of a patient with a SCC affecting more than 1/3 of the lower lip, who underwent resection of the primary lesion and a conservative reconstruction of the lesion’s region, due to the great local mobility, aimed at preserving the functionality without compromising the aesthetic outcome.

Keywords: Carcinoma, squamous cell; Mouth neoplasms; Reconstruction

Squamous cell carcinoma is the second more frequent non-melanoma skin cancer. It is linked to the sunlight exposure and the clinical presentation in the foot is atypical, and rarely develops metastasis. The authors report a case of a patient with an exuberant clinical picture of squamous cell carcinoma in the foot, with long development and absence of metastasis. Surgical treatment was successfully performed.

Keywords: Foot; Melanoma, amelanotic; Neoplasms, squamous cell

We report the case of a 13-year-old girl with a diagnosis of extra-abdominal desmoid fibromatosis, a neoplasm of benign origin but uncommon in the soft tissues. This study aims to expose the rarity of the tumor and its challenging therapeutic approach due to its high frequent local recurrence rates. For the treatment, Mohs micrographic surgery was performed in two stages to obtain a free margin.

Keywords: Fibromatosis, Aggressive; Mohs Surgery; Neoplasms

Nevus sebaceous of Jadassohn is a congenital skin hamartoma often located on the face and scalp. A small percentage of these tumors evolve into malignant lesions, including basal cell carcinoma. We report a case of an elderly patient with nevus sebaceous since early childhood that evolved with a malignant transformation from the lesion to basal cell carcinoma. The treatment performed was surgical excision using Mohs surgery.

Keywords: Nevus, Sebaceous of Jadassohn; Carcinoma, Basal Cell; Mohs Surgery