Introduction: The most common type of skin cancer is basocellular carcinoma, which frequently occurs on the face.Aesthetic and functional damage during treatment are of great concern to patients; Mohs Micrographic Surgery is a safe treatment that allows tissular preservation with minimum aes- thetic damage. Objective: To evaluate whether using Mohs Micrographic Surgery to treat basocellular carcinomas located in aesthetically important areas of the face preserves healthy tissue. Methods: Surgical procedures (n = 49) performed in the ABC Medical School in 2008 to treat tumors located in the peribuccal, periocular and alar areas, and in the ears,were evaluated.The tumors were classified according to clinical and histological features, and the surgical margins were analyzed and compared to those recommended by the literature.The patients were re-evaluated 2 years after treatment. Results: The margins removed by Mohs Micrographic Surgery were much smaller than those recommended for excisional surgery, with important tissular preservation. Conclusion: Mohs Micrographic Surgery permitted the preservation of healthy tissue (56-86%) in the treatment of basocellular carcinomas located in aesthetically important areas of the face, with minimal damage.Thus it is a safe therapeutic and aesthetical option in the treatment of facial basocellular carcinomas.

Keywords: MOHS SURGERY, CARCINOMA, BASAL CELL, ESTHETICS, FACE, SKIN NEOPLASMS

Solitary pink lesions of the face may have nonspecific dermoscopic patterns, and are thus deemed difficult to diagnose. Differential diagnoses to consider are: actinic keratosis, squamous cell carcinoma, basal cell carcinoma, and amelanotic melanoma. Confocal microscopy can be used as an auxiliary clinical examination in their diagnosis and in determining the most significant sites for carrying out a biopsy. The authors describe a case that illustrates the usefulness of a confocal microscopy examination in pink lesions.

Keywords: DERMOSCOPY, MICROSCOPY, CONFOCAL, CARCINOMA, BASAL CELL, KERATOSIS ACTINIC

Lip cancer corresponds to 25-35% of all oral cancers. Squamous cell carcinoma is the most common histological type in this location (95%). Various wound reconstruction options are described for the exeresis of this type of tumor in the lower lip - the choice depending on the surgeon's experience and the proportion of the final defect regarding the dimensions of the lip. The present article describes the case of a male patient with a wound in the lower lip that was histologically diagnosed as an invasive squamous cell carcinoma. Mohs surgery was implemented and a transposition flap (Abbé flap) was used in the reconstruction of the upper lip. The complete opening of the mouth, without functional impairment of the speech or chewing function, and a favorable aesthetic result, were observed in the follow-up, thus demonstrating the usefulness of this type of reconstruction.

Keywords: MOHS SURGERY; CARCINOMA, SQUAMOUS CELL; RECONSTRUCTION

Lesions in difficult locations within the auricular pavilion have been a major challenge for dermatologic surgeons, since access to their surgical approach tends to be complicated. In this article, the authors describe a case of basal cell carcinoma affecting the lower part of the left auricular concha that was resected by Mohs micrographic surgery, whose approach proved to be challenging. The authors describe a tactic to gain better access and visibility of the surgical field and facilitate the implementation of the procedure.

Keywords: EAR AURICLE; MOHS SURGERY; CARCINOMA, BASAL CELL

Adequate healing of surgical wounds is influenced by the operative technique, the presence of postoperative complications and the patient's life habits. We report the case of a patient submitted to excision of basal cell carcinoma by Mohs micrographic surgery and reconstruction with palpebral cutaneous grafting. In the postoperative period there was graft necrosis due to poor perfusion of the surgical bed imputed to smoking. Smoking interferes with plasma embolization and graft neovascularization, as well as promoting oxidative stress and endothelial dysfunction. The surgeon should counsel the cessation of smoking for at least four weeks prior to the procedure in order to avoid further risks of complications.

Keywords: Carcinoma, basal cell; Graft survival; Mohs surgery; Necrosis; Smoking

There are a few descriptions in the literature on surgical techniques for the closure of synchronous facial defects. We report three cases of patients with synchronous lesions on the face, which were reconstructed using the following types of flaps: Yin-Yang double-opposing rotation; Burrow's triangle advancement; and a combination of the dorsal nasal flap with the transposition flap. Reconstructions of synchronous facial defects represent challenges to dermatologic surgeons, especially when one of the lesions is located in the nose. In cases involving relatively small defects and not so far apart, there is the possibility of a single flap to close both defects.

Keywords: Surgical flaps; Mohs surgery; Carcinoma, basal cell