Hyaluronic acid is the currently most used filler in dermatology due to its low risk of adverse events. The objective of this study is to report a case of granulomatous reaction after filling with two types of hyaluronic acid, in the perioral region and in the nasolabial folds. A female patient with rheumatoid arthritis treated with leflunomide presented onset of symptoms 30 months after filling. Autoimmune diseases may facilitate the occurrence of complications and should be followed carefully before filling with hyaluronic acid. As already reported with the use of interferon and omalizumab, granulomatous reaction to fillers may occur after use of leflunomide.

Keywords: HYALURONIC ACID; GRANULOMA; RHEUMATOID ARTHRITIS; FOREIGN-BODY REACTION

Basal cell carcinoma (BCC) is the most common skin cancer¹. Among the risk factors for its development are exposure to ionizing and non-ionizing radiation, some chemicals, and previous scars.² However, the most important factor is exposure to ultraviolet radiation, which explains the higher incidence of this neoplasm in photo-exposed areas.¹ BCC in unexposed areas is uncommon. The purpose of this report is to describe a case of recurrent BCC in the vulva, to demonstrate the importance of dermatological examination in unusual areas, and to report the application of Mohs micrographic surgery.

Keywords: Basal cell carcinoma; Vulvar diseases; Vulvar neoplasms

Acral amelanotic melanoma is rare and can mimic many entities, such as eccrine poroma, squamous cell carcinoma, plantar wart, and chronic ulcers. Due to the variety of possible differential diagnoses, it is a challenging and frequently late diagnosis. Dermoscopy features can help in early diagnosis. The dermatologist should keep this diagnosis in mind when faced with a pink, progressively growing, irregularly shaped lesion, mainly if located on the hands and feet.

Keywords: Dermoscopy; Melanoma amelanotic; Skin neoplasms; Oncology; Foot ulcer

Aneurysmal dermatofibroma (ADF) is a rare benign tumor originating in the dermis. It is most common in the lower limbs of women over 30 years. Its etiology is unknown, and histopathological examination confirms the diagnosis. This paper presents a case of ADF with an exuberant presentation in a young female patient with a pedunculated tumor in the right pretibial region, measuring 12 cm in greatest diameter. This report aims to demonstrate an infrequent variant of dermatofibroma with significant growth and emphasize the importance of lesion excision and follow-up because of the high recurrence rate.

Keywords: Histiocytoma, Benign fibrous; Dermatology; Dermoscopy