Reconstruction of the scalp after suspected skin lesions excision is a challenge. Tamir et al. described the three-point-advancement (Mercedes flap) to close circular wounds. These tissue advancements create triangles in the edges, which must be removed. However, extensive lesions do not allow the three points to join, preventing central closure. Valesky et al. described the central closure using total skin grafts made from the triangles. The literature lacks these case reports, making it difficult to incorporate them into surgical practice. We applied this modified technique to five patients with good aesthetic and functional results.

Keywords: Scalp; Surgical flaps; Plastic surgery procedures; Skin transplantation; Skin neoplasms

Schwannomas are benign nerve sheath tumors derived from Schwann cells. The sites most often involved are the head and neck (25-48%), with only 1% occurring in the oral cavity. Most schwannomas occur in adult individuals between the third and fifth decades of life. Lip involvement is extremely rare during childhood and adolescence, with few reports in the literature. The prognosis is favorable and surgical excision is the treatment of choice. We report an interesting case of upper lip schwannoma in an adolescent with successful surgical treatment and no evidence of recurrence after 4 years.

Keywords: Neurilemmoma; Lip; Neoplasms; Schwann Cells.

BACKGROUND: Keloids are abnormal proliferations of scar tissue that do not regress spontaneously. Studies on the quality of life in patients with auricular keloids are rare. This condition is a frequent complaint, occurring in a highly visible area.
OBJECTIVE: To assess the impact of auricular keloids on the quality of life of affected individuals, demonstrating that psychological and physical symptoms are common and significantly affect patients.
METHODS: This is a cross-sectional, observational analytical study conducted in São Paulo. Patients with auricular keloids completed the QualiFibro questionnaire, a validated tool specific for assessing quality of life in individuals with auricular keloids.
RESULTS: Seventeen patients with auricular keloids were analyzed. The questionnaire revealed that most participants experienced some degree of physical impairment (76% reported itching, and 58% reported pain in their keloids). All participants showed psychological distress to varying degrees.
DISCUSSION: Patients often associate their keloids with feelings of shame and low self-esteem. We believe that raising awareness of the negative psychological impact of this condition can help dermatologists better understand these patients’ concerns and provide empathetic support, aiming to make them feel more comfortable in their own skin.

Keywords: Keloid; Quality of Life; Ear Auricle.