Isolated keloid treatment has variable and often unsatisfactory results. The combination of therapies has proven to be an effective alternative mainly for recalcitrant cases. Surgical excision and immediate postoperative electron beam irradiation is an effective alternative in healing and reducing the recurrence rate of these lesions. The authors describe a patient with recalcitrant bulky keloid who had a good therapeutic outcome.

Keywords: Ear; Keloid; Radiotherapy

Rhinophyma is a disfiguring and progressive disease of the nose with high prevalence. Despite being considered a benign condition, many patients have sought curative treatments due to aesthetic deformity and social stigmatization. There are several surgical techniques described in the treatment of this disease. This report aims to present a case that required an unusual therapeutic approach for the treatment of rhinophyma, given the patient's multiple comorbidities. The procedure was performed with no complications in the intra and postoperative period. The patient maintains an outpatient follow-up with a good long-term aesthetic result.

Keywords: Dermatologic Surgical Procedures; Rhinophyma; Rosacea

Primary cutaneous B-cell lymphomas are non-Hodgkin lymphomas presenting only in the skin and represent 25% of all primary cutaneous lymphomas. Based on their clinical behavior, they are classified into indolent and intermediate forms. Treatment of indolent forms includes surgery, radiotherapy, and, in extensive disease, rituximab. We report a case of a 57-year-old woman with a single nodule in the left arm treated with surgical excision with 5-mm security margins, without relapse after 36 months. Surgery is a therapeutic option in these lymphomas without compromising disease-free survival.

Keywords: Lymphoma B-Cell; Lymphoma B-Cell marginal zone; Lymphoma non-Hodgkin; Surgical oncology

INTRODUCTION: The advent of squamous cell carcinomas (SCC) from chronic dermatoses is known but little explored. Although rare, tumors originating there have a worse prognosis, in part due to late diagnosis.
OBJECTIVES: This study aims to survey cases of squamous cell carcinoma developed on previous dermatoses diagnosed between 2000 and 2020 in a tertiary health service.
METHODS: This is a quantitative and retrospective study through biopsy reports survey and medical records review.
RESULTS: From an initial list of 11,249 histological reports compatible with squamous cell carcinoma, we obtained a final list of 10 patients. The study findings corroborate the literature regarding some known risk factors: abundant and chronic sun exposure, older than 50 years, lower skin phototypes, and immunosuppression. We also found a high frequency of smoking and lichenoid dermatoses (5/10 patients) in the studied population, including chronic cutaneous lupus erythematosus and hypertrophic lichen planus.
CONCLUSIONS: It is not possible to predict the primary risk factors for the development of squamous cell carcinomas regarding previous dermatoses, although there is a tendency for their appearance in lichenoid dermatoses and those with longer evolution.

Keywords: Skin diseases; Squamous cell carcinoma; Lupus erythematosus, Cutaneous; Lichen planus

Fibromyxosarcoma is a rare subtype of soft tissue sarcoma characterized by the presence of spindle cells and myxoid matrix. We report the case of an older patient who presented with progressive growth of a nodule in the interscapular region, and further investigation confirmed the diagnosis of high-grade fibromyxosarcoma. Notably, this neoplasm more commonly occurs in the lower limbs and may exhibit recurrence associated with increased histological grade. Therefore, early diagnosis and treatment are crucial for mitigating morbidity and mortality. We emphasize the significance of diagnosing an atypical case and providing timely therapeutic intervention, contributing to the optimization of clinical outcomes.

Keywords: Sarcoma; Neoplasms, Connective and Soft Tissue; Solitary Fibrous Tumors

Pain and anxiety management during pediatric dermatological procedures is a crucial aspect of medical care. Skin biopsies can cause stress and discomfort in children, negatively impacting the relationship between health care providers, patients, and caregivers. This study describes a local anesthesia protocol based on non-pharmacological techniques, consisting of prior explanation, parental support, visual distraction, and the use of cold or vibration before pharmacological anesthesia. Implementing this protocol may reduce pain and anxiety perception while offering a low-cost, low-tech, and safe care option.

Keywords: Dermatology; Pediatric Anesthesia; Biopsy; Pain

We report 5 cases of melanoma with initial clinical presentations suggestive of common dermatoses, including seborrheic keratosis, basal cell carcinoma, Bowen disease, actinic keratosis, and solar lentigo. In 4 cases, documented dermoscopy revealed findings discordant with the initial clinical impression and prompted biopsy; in 1 case, lesion evolution and recurrent bleeding prompted excision, confirming a thick nodular melanoma. This series highlights how familiar clinical patterns may promote diagnostic anchoring and delay suspicion. Lesion evolution, patient concern, total-body skin examination, systematic dermoscopy, and a low threshold for biopsy are practical strategies for reducing biases and improving early diagnosis.

Keywords: Melanoma; Dermoscopy; Diagnostic Errors