Introduction: Subcutaneous mycoses caused by dematiaceous fungi are classified according to their characteristics in the tissue: chromoblastomycosis (with the presence of fumagoid corpuscles), phaeohyphomycosis (with dematiaceous septate hyphae) and eumicetoma (with grains composed of septate hyphae). Several treatments are proposed, among them, surgical excision. Surgical treatment is more indicated in cases where there is localized infection and where excision is possible, yielding good therapeutic outcomes and low recurrence rates.
Objective: To describe the experience of a dermatological service in the surgical treatment of subcutaneous mycosis cases caused by dematiaceous fungi, discussing the surgical approach and its results.
Methods: A retrospective study was carried out with the descriptive analysis of cases treated from April 2014 to December 2016, at a dermatological clinic in the Brazilian Southeast city of São Paulo. All cases diagnosed with subcutaneous mycoses caused by dematiaceous fungi were included and surgically treated with total exeresis of the lesion.
Results: A total of 7 cases were analyzed – 2 eumicetomas, 1 chromoblastomycosis and 4 phaeohyphomycoses. Only one on the cases was not treated at an ambulatory surgical center. All cases progressed without sequelae or recurrences during the clinical follow-up.
Conclusions: When surgical treatment is possible, the exeresis of the lesion is a good therapeutic option in cases of subcutaneous mycoses caused by dematiaceous fungi.

Keywords: CHROMOBLASTOMYCOSIS; PHAEOHYPHOMYCOSIS; BACTERIAL INFECTIONS AND MYCOSES; MYCOSIS; MYCETOMA; AMBULATORY SURGICAL PROCEDURES; BLOODLESS MEDICAL AND SURGICAL PROCEDURES; HISTOLOGY; THERAPEUTICS

Introduction: In the Brazilian public health system, the current demand for dermatological procedures is greater than the offer, resulting in a waiting list of patients bearing dermatoses to be treated surgically. Aimed at reducing that waiting list, a collective effort of surgical procedures was carried out in the tertiary public health service. The corresponding data on the patients and lesions is disclosed in the present study. Objective: To assess the profile of the patients – and respective skin lesions – who are awaiting to undergo dermatological procedures. Methods: A simple descriptive profile analysis of the patients, treated dermatoses and procedures performed was carried out. Results: Thirty-one patients (aged between 21 and 95 years, mean = 63.7 years). Seventeen (54.83%) were women and 14 (45.17%) were men. Thirty-eight lesions were treated: 21 neoplastic (carcinomas and melanomas), 8 pre-neoplastic (actinic keratoses) and 9 non-neoplastic (nevi, keloid and neurofibroma). Conclusions: The present article is relevant due to the fact it identifies cases and patients awaiting dermatological surgical procedures in the public health system. Based on it, a better planning of public health strategies in the dermatological field should be possible. Also, it highlights the importance of the dermatologist physician’s action in the public health, diagnosing and treating pre-neoplastic and neoplastic lesions.

Keywords: DERMATOLOGY; AMBULATORY HEALTH SERVICES; HEALTH CENTERS; POPULATION STUDIES IN PUBLIC HEALTH; PUBLIC HEALTH; PUBLIC HEALTH ADMINISTRATION; NEOPLASMS; MELANOMA; CARCINOMA; CARCINOMA, BASAL CELL

Nasal surgical defects resulting from the removal of non-melanoma skin cancer represent a challenge for the surgeon due to the anatomical complexity and the high functional and aesthetic relevance of the region.The purpose of this paper is to demonstrate the jigsaw puzzle advancement flap. Resection of basal cell carcinoma was performed in the patient's perialar region, followed by the reconstruction with the jigsaw puzzle advancement flap, with excellent aesthetic and functional results.The presented technique is useful and not yet widespread, and it should be part of the dermatological surgeon's arsenal in the reconstruction of surgical defects located in the nasal ala-perialar region.

Keywords: Nose; Reconstructive surgical Procedures; Surgical flaps

The reconstruction of deep surgical defects of the nasal tip and wing of the nose often presents a challenge to the surgeon. In these cases, full-thickness skin grafting is widely used, but it often results in sinking or graft depression. We present a surgical technique that is easy to perform and reproducible; nonetheless still very little diffused in Brazil: the “Drumhead” graft. This method performs the grafting of a rigid plastic suspension together with the full-thickness skin graft. Thus, this technique constitutes another tool for the dermatological surgeon to prevent irregularities of undesirable contours, graft depression, and nasal vestibule collapse.

Keywords: Nose; Nose neoplasms; Skin neoplasms; Skin transplantation

Small surgical defects of the lower lip can be reconstructed through direct closure. Full-thickness defects with more than 30% involvement require complex reconstructions with high morbidity. We report the case of a patient diagnosed with squamous cell carcinoma in the lower lip whose resection resulted in a surgical defect of 45% of the lower lip. The reconstruction combined two well-established techniques: unilateral myomucosal advancement flap and M-plasty. This association acted synergistically, enabling the closure of the surgical defect with easy execution, low morbidity, and excellent aesthetic and functional results.

Keywords:

Small surgical defects of the lower lip can be reconstructed through direct closure. Full-thickness defects with more than 30% involvement require complex reconstructions with high morbidity. We report the case of a patient diagnosed with squamous cell