Koenen tumors are nail fibromas included among the main diagnostic criteria of tuberous sclerosis. Elongated and thin papules, firm, with smooth surface and broad base characterize these lesions, which are slightly erythematous and present varying sizes. Koenen tumors commonly affect toenails and result in aesthetic and functional concerns associated with deformities, pain, and bleeding. Several therapeutic options are described for Koenen tumors; however, there is a lack of consensus in the literature regarding standard treatment. We report the case of a patient who underwent surgery with excellent outcomes. Additionally, we discuss the advantages and disadvantages of each therapeutic modality.

Keywords: Dermatologic Surgical Procedures; Fibroma; Nails; Tuberous Sclerosis

INTRODUCTION: Cutaneous cancer has a high incidence, can be screened with dermatological clinical examination and confirmed by cutaneous biopsy.
OBJECTIVE: To verify the prevalence of pathological diagnoses for suspected non-melanoma skin cancer (NMSC) lesions in a Reference Service.
METHODS: Observational and cross-sectional study. Patients with indication of skin biopsy for suspected NMSC were included. Variables analyzed: age, gender, personal history of skin cancer, number of biopsies, biopsy site, and pathological outcome, divided into Group 1 (neoplastic lesions); Group 2 (premalignant lesions), and Group 3 (benign lesions).
RESULTS: A total of 287 patients, with an average of 1.33 biopsies per patient. The median age in the sample was 71 years, and 56.1% were women. Personal history of skin cancer: 44.95%. General sample: group 1: 62%; group 2: 21% and group 3: 17%. Neoplasms found: 68% were BCC, 30% were SCC, and other neoplasms: 2%. In the group of premalignant lesions: mainly actinic keratosis; in the group of benign lesions: diagnostic variety. The cephalic segment was the most frequently biopsied topography (58%).
CONCLUSIONS: In this study, we showed a higher incidence of skin cancer in women, with the majority of elderly patients being the most frequent diagnosis of BCC.

Keywords: Basal Cell; Biopsy; Carcinoma; Neoplasms; Skin neoplasms; Squamous cell.