Basal cell carcinoma is the most common malignant skin tumor. Reflectance confocal microscopy is a non-invasive technique that provides real-time, in vivo, horizontal tissue images, at a quasi-histological resolution, by employing a low-power laser beam of 830 nm. In this paper, we review the major morphological criteria for diagnosing this tumor using reflectance skin confocal microscopy.

Keywords: CARCINOMA, BASAL CELL, MICROSCOPY, CONFOCAL, DIAGNOSIS

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

This study demonstrated the clinical and histologic result of the treatment of one disseminated superficial actinic porokeratosis patient with non-ablative fractional laser. The patient was treated with seven sessions of 1340-nm Nd:YAP laser, with 4 or 5 week-intervals. Biopsies and photographs were performed before and after treatment, which was well tolerated and lead to improvement in the erythema and texture of the lesions. There was a 1-year follow-up. Histopathologic examination after treatment revealed little changes in the cornoid lamella.

Keywords: Biopsy; Laser Therapy; Lasers; Porokeratosis

Extramammary Paget's disease is a slow-progressing, cutaneous adenocarcinoma of the apocrine glands with an uncertain etiology. The standard treatment is surgical removal of the tumor. However, the usual surgical methods - wide local excision and Mohs micrographic surgery - pose challenges and high recurrence rates. Often, these are extensive lesions with poorly defined boundaries located in critical anatomical regions. Additionally, they exhibit unpredictable subclinical intraepithelial spread. We present a case of a recurrent extramammary Paget's disease successfully treated with peripheric Mohs micrographic surgery associated with rapid immunohistochemistry for CK8/18.

Keywords: Paget Disease, Extramammary; Mohs Surgery; Immunohistochemistry