Dermatofibrosarcoma protuberans is a spindle cell neoplasm of intermediate malignancy, nonetheless it presents a high risk of local recurrence. It mainly affects the trunk and limbs, and is rare on the face. The treatment of the tumor can be carried out using conventional surgery with wide surgical margins or Mohs micrographic surgery. Radiation and chemotherapy can be indicated in selected cases. The present article reports the case of a 39-year-old male patient with a 0.7cm yellowish papule on the forehead, whose biopsy and immunohistochemistry confirmed the tumor's diagnosis. The lesion was treated through Mohs micrographic surgery with good aesthetic results.

Keywords: DERMATOFIBROSARCOMA; SARCOMA; MOHS SURGERY

Primary axillary hyperhidrosis is a common disease that affects the social and professional lives of individuals. There are various treatments described in the literature, such as topical, systemic, and surgical. The present study describes the technique applied in a female patient, bearer of axillary hyperhidrosis, who underwent surgical treatment of axillae, progressing with significant regression of local sweating. The objective of the present study is to demonstrate the effectiveness of this surgical technique, with low complication rates, as a therapeutic option for axillary hyperhidrosis.

Keywords: HYPERHIDROSIS; AXILLA; DERMATOLOGIC SURGICAL PROCEDURES; SWEAT GLANDS.

Rhinophyma is characterized by the hyperplasia of sebaceous glands in the nasal region, associated with a nodular thickening of the skin, enlargement of the pores, and fibrosis in the later stages. It occurs most commonly in male patients bearing rosacea, and may be associated with phymas in the region of the mentum (gnatophyma), ears (otophyma) and forehead (metophyma). The present article describes a case of giant rhinophyma with significant impact on the patient's quality of life, hampering breathing, sleeping, and eating. The lesion was successfully treated with electrosurgery.

Keywords: ELECTROSURGERY; RHINOPHYMA; DERMATOLOGIC SURGICAL PROCEDURES

Introduction: Mohs micrographic surgery is a technique that offers high cure rates for non-melanoma skin cancer.
Objective: To describe the clinical and epidemiological profile of patients who underwent Mohs micrographic surgery in a reference center in dermatologic surgery.
Methods: Medical records of patients who underwent Mohs micrographic surgery in the period 2014-2015 at a dermatology reference center, in the city of Mogi das Cruzes (SP, Brazil), were analyzed.
Results: The patients' ages ranged from 38 to 87 years; of these 54% were women. The most affected topography was the nose (54% of patients). Previous history of skin cancer was positive in 62% of cases. The indication driver for micrographic surgery was the lesion's location in 67% of the patients, followed by the size (23%) and tumor recurrence (10%). The most prevalent intraoperative diagnosis was basal cell carcinoma (90%).
Conclusions: Mohs micrographic surgery is an excellent therapeutic option in cases of tumors of aggressive nature, large diameter and high-risk location. This study is in line with the current literature regarding the epidemiological data linked to the occurrence of nonmelanoma skin cancer.

Keywords: MOHS SURGERY; SKIN NEOPLASMS; DERMATOLOGIC SURGICAL PROCEDURES

Introduction: Hyperhidrosis is a common disease characterized by excessive sweating. Several treatment options are described as axillary liposuction and laserlipolysis.
Objective: To compare the effectiveness of two treatment methods for axillary hyperhidrosis – one exclusively surgical (liposuction) and the other employing invasive laser therapy (laserlipolysis) – using a prospective, comparative study with a one-year follow up.
Methods: Liposuction was carried out in the right axilla, while laser lipolysis was performed in the left axilla. The evaluation was conducted using the starch-iodine test, comparative histological analysis and patient self-assessment questionnaires.
Results: Twelve patients took part in the study. The starch-iodine test indicated decreased sweating in all patients within one year after the procedures, while the histological analyses showed absence or reduction of the secreting ducts and acini on both sides and in all cases. After one year of follow-up, the patient's satisfaction index measured by the questionnaires remained positive in all cases, with 75% asserting maximum satisfaction, and 25% reporting difference between the sides (better results were described in the right hand side axilla).
Conclusions: Both techniques showed similar effectiveness after one year of follow-up. Laserlipolysis had a lower frequency of postoperative complications.

Keywords: LASERS; LASER THERAPY; DERMATOLOGY; DERMATOLOGIC SURGICAL PROCEDURES

Dermatofibrosarcoma protuberans is an uncommon and relapsing fibrohistiocytic tumor of intermediate malignancy. Its rarest variant is known as atrophic, morphea type or dermatofibrosarcoma non protuberans and its clinical diagnose is difficult. There are not well established dermatoscopic criteria, so the diagnosis is histopathologic. There are advances in immunohistochemical and genetic that help the diagnosis and complete surgical excision. It is reported a case of atrophic dermatofibrosarcoma in a 27 years patient ant it is reviewed the clinical, dermoscopic, histological and genetic aspects.

Keywords: DERMOSCOPY; NEOPLASMS; DERMATOFIBROSARCOMA

Case report of a 16-year-old female patient with diagnosis of subungual exostosis in the right hallux with clinical and histopathological diagnosis, submitted to total excision of the lesion and follow-up for five years with excellent aesthetic result.

Keywords: EXOSTOSES; BONE NEOPLASMS; DERMATOLOGIC SURGICAL PROCEDURES

Hidradenitis suppurativa is a chronic inflammatory, recurrent and debilitating skin disease. Its etiopathogenesis involves follicular occlusion and genetic, environmental and immunological factors. Diagnosis is predominantly clinical, and the therapeutic approach is a major challenge due to its impact on the patient's quality of life. The surgical option is the most indicated in severe cases, nevertheless there is no consensus on the ideal treatment, as outcomes are diverse, and the aesthetic aspect after the procedure is generally unfavorable. This article was aimed at reporting a surgical option with primary wound closure, whose aesthetic result was superior to those derived from traditional techniques.

Keywords: HIDRADENITIS SUPPURATIVA; HIDRADENITIS; DERMATOLOGIC SURGICAL PROCEDURES; DERMATOLOGY; THERAPEUTICS

Introduction: Tuberous sclerosis is a dominant autosomal genodermatosis, classically characterized by facial angiofibromas, fibrotic plaques, periungual fibromas, leaf-shaped hypochromic maculae and fibrous frontal plaques.
Case report: A patient bore this disease, with Koenen tumors in all nail beds of hands and feet, which were resistant to the conventional treatment — simple excision and electrosurgery. Amputation of the nail beds was performed followed by reconstruction with full thickness skin grafts.
Conclusion: The amputation of the nail apparatus and reconstruction with full thickness skin grafts in aggressive, recurrent or high morbidity cases can be an effective therapeutic option.

Keywords: DERMATOLOGY; DERMATOLOGIC SURGICAL PROCEDURES; TUBEROUS SCLEROSIS; SKIN TRANSPLANTS

Introduction: Molluscum contagiosum is a dermatovirosis caused by a poxvirus. In the literature there are descriptions of different therapeutic approaches of this infection.
Objective: To evaluate the efficacy of imiquimod – isolated and associated with curettage – in the treatment of molluscum contagiosum.
Methods: Group A: 20 patients used 5% imiquimod cream 3 times a week for 6 weeks. Group B: 10 patients used a creamy base 3 times a week, for 6 weeks. After the initial 6 weeks, all patients underwent curettage.
Results: Group A: 31% decrease in the number of lesions in the 6th week, with a curettage effectiveness of 97.6%; Group B: 4.8% increase in the number of lesions in the 6th week, with a curettage effectiveness of 81.1%. The mean value for the pain level during curettage was 1.8 for Group A and 3.0 for Group B.
Conclusions: Due to the facts that the rate of cure of contagious molluscum lesions increased and the pain decreased when the curettage procedure was conducted after the use of the immunomodulator, it was possible to conclude that the association of 5% imiquimod cream to the curettage may be a therapeutic possibility.

Keywords: Molluscum Contagiosum; Dermatology; Dermatologic Surgical Procedures

INTRODUCTION: Dermatofibrosarcoma protuberans (DFSP) is a local aggressive sarcoma that presents 60% of recurrences. Rarely it presents lung metastasis too.
METHODS: 41 years old man presented a soft tumor in his right hallux for two years. Histopathology has shown spindle-shaped cells arranged in a storiform manner, and immunohistochemistry was CD34 positive.
DISCUSSION: The literature describes some clinical types of DFSP. The most common are: confluent nodules forming a plaque, sometimes similar to keloids, tumoral lesions, and atrophic plaques.
CONCLUSION: DFSP cases simulating a subcutaneous cyst have been described in the literature; nevertheless, it is an unusual presentation of this tumor.

Keywords: Dermatofibrosarcoma; Sarcoma; Surgical Procedures, Minor

Dermatofibrosarcoma protuberans is a locally aggressive sarcoma of intermediate malignancy that predominates in the range of young adults to middle age. Congenital or childhood lesions are rare but have been reported. It can be misdiagnosed and incompletely excised in the early stages, which increases the risk of recurrence. The present article reports the case of a 24-year-old male patient presenting a hyperchromic macula in the abdominal region from birth that evolved into a tumor after several surgical approaches. Biopsy and immunohistochemistry confirmed the diagnosis of dermatofibrosarcoma protuberans, and the lesion was excised with a 3 cm margin.

Keywords: Dermatofibrosarcoma; Neoplasms, Fibrous Tissue; Sarcoma

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

O fibroxantoma atípico (FXA) é um tumor mesenquimal raro que geralmente acomete pacientes com idade avançada, do sexo masculino, em áreas fotoexpostas. É mais frequente na cabeça e pescoço, mas também pode ocorrer no tronco e nas extremidades. Atualmente, é considerado um tumor benigno de diagnóstico por exclusão, com baixa taxa de recidiva e metástase. O tratamento é realizado com excisão cirúrgica, o que permite o diagnóstico por avaliação histológica e imuno-histoquímica.

Keywords: Tórax; Oncologia Cirúrgica; Dermoscopia; Neoplasias; Imuno-Histoquímica; Sarcoma

Bednar tumor is a rare variant of dermatofibrosarcoma protuberans. A 45-year-old woman presented with a progressively enlarging bluish macule on the shoulder. Biopsy revealed a pigmented spindle cell neoplasm, with immunohistochemistry positive for CD34 and negative for S100 and SOX-10. Surgical excision with margin mapping was performed. Surgical treatment with margin control is the gold standard for the management of Bednar tumor. This technique ensures complete resection, with outcomes comparable to those of Mohs micrographic surgery. This case highlights the importance of clinical suspicion in atypical hyperpigmented skin lesions.

Keywords: Dermatofibrosarcoma; Immunohistochemistry; Dermatology