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

INTRODUCTION: Photoprotection is indicated to reduce the exposure to cutaneous actinic damage and it is important to prevent skin cancer. The face is the most irradiated area of the body and is also where skin cancers most commonly occur.
OBJECTIVE: To evaluate the amount of sunscreen applied and its facial coverage in patients previously diagnosed with skin cancer, treated at a Brazilian public institution.
METHODS: Quasi-experimental study involving 40 patients undergoing skin cancer follow-up. Participants were asked to apply sunscreen on their face, as usual, and the mass used was measured. After, participants were photographed under Wood's light to evaluate the homogeneity of the sunscreen´s coverage, and facial sunscreen coverage failure.
RESULTS: Fourteen (35%) participants applied an estimated amount lower than recommended (2mg/ cm2). The regions with smallest coverage were the ears and the "H" area of the face.
CONCLUSIONS: The insufficient or heterogeneous sunscreen application on face, neck and ears may promote a false perception of protection, leading to irresponsible exposure. As the population ages and the incidence of skin cancers increases, it is essential to stimulate photoprotection, with appropriate information, especially among high-risk individuals.

Keywords: Sunscreening Agents; Skin Neoplasms; Sunburn; Sunlight

INTRODUCTION: Dermatobia hominis is one of the main etiologic agents of furunculoid myiasis. It is more common in intertropical countries and induces the formation of a papule or nodule in the skin with a central orifice. When the lesion's diagnosis is not made or when the larva does not go out, it can progress to the formation of a tumor. We report a rare case of a lipoma-simulating lesion in the lower limb of a man living in the countryside. The etiological diagnosis was made exclusively through histopathological examination, which showed a cyst with exogenous material to the center, compatible with D. hominis, in a clear degradation process.

Keywords: Larva; Lipoma; Myiasis

Blue nevus is a benign lesion arising from dermal melanocytes containing large amounts of melanin. The agminated variant presents a cluster of blue nevus lesions with linear or blaschkoid distribution. We report two cases of patients with agminated blue nevus that developed on previous acne scars, and dermoscopy helped a lot in the differential diagnosis. This is the first occurrence found in the literature of agminated blue nevus that appeared on a previous scar, which may have occurred by chance or as a result of the collagen remodeling process inherent to the healing process.

Keywords: Scar; Collagen; Dermoscopy; Nevus blue

We report a case of a 72-year-old man who underwent surgical excision of a keratoacanthoma centrifugum marginatum (KCM) located on the left forearm. It is an uncommon variant of keratoacanthoma, which can assume large dimensions (up to 20 cm) and does not tend to spontaneous regression. The lesion is usually single, with raised borders, and has progressive centrifugal growth associated with central healing and atrophy. Due to its rarity and lack of pathognomonic histopathological features, KCM can be a diagnostic challenge for dermatologists and pathologists.

Keywords: Keratoacanthoma; Neoplasms; Skin neoplasms