Introduction: The granular cell tumor was first described by Abrikossoff in 1926. It is a benign, uncommon neoplasia, most frequently found on the tongue. It occurs in the vulva in 5 to 6% of cases. Its histogenesis is not known for sure, but is probably linked to Schawann cells. It is treated surgically, with a good prognosis. The tumors may recur, and some may become malignant according to the literature. The authors describe a case of a vulvar nodule with a histopathologic diagnosis of granular cell tumor, which was successfully treated with surgery.

Keywords: VULVA, VULVAR DISEASES, VULVAR NEOPLASMS, GRANULOSA CELL TUMOR

This article describes the case of a soft fibroma of unusual size and development located in the vulva of a post-menopausal woman.

Keywords: FIBROMA, NEOPLASMS, FIBROUS TISSUE, VULVAR DISEASES, VULVAR NEOPLASMS

Extramammary Paget's disease is a rare cutaneous neoplasm typically occurring in the vulva of Caucasian women after menopause. Clinically, the most common symptom is pruritus, when an erythematous, desquamative and eczematous lesion can be observed. Due to the rarity and nonspecific appearance of the disease, it can be confused with other dermatological conditions, delaying diagnosis. The present case demonstrates a form of vulvar extramammary unilateral Paget's disease confirmed by anatomical pathologic and immunohistochemical study. The standard treatment used for the disease in this case was surgical and the patient underwent complete excision of the lesion, with continued monitoring every six months.

Keywords: GENITAL NEOPLASMS, FEMALE; VULGAR NEOPLASMS; VULVAR DISEASES; PAGET DISEASE, EXTRAMAMMARY.

Eccrine spiradenoma is a rare benign adnexal epithelial neoplasm characterized by a bluish-pink, slow-growing solitary nodule, coursing with paroxysmal pain, mainly in young adults. It is most commonly located in the trunk and extremities. Bleeding and/or ulceration are common in the giant vascular variant, which is characterized by a size greater than 2 cm in diameter and a high degree of vascularization seen on histology. Its clinical characteristics are unspecific and require biopsy with histological analysis for diagnosis. Its histology presents one or more basophilic intradermal lobules enveloped in a fibrous capsule without connection to the epidermis. It presents two types of cells: small cells with dark nuclei in the periphery and large cells with light nuclei in the center. An accurate diagnosis is important due to the fact that it can develop into a potentially fatal malignancy - which is a rare phenomenon and occurs most often in the multiple variant. A rare case of eccrine spiradenoma in the abdomen with bleeding associated is described in the present paper, as well as a discussion on possible treatments.

Keywords: ECCRINE SPIROADENOMA, BENIGN EPITHELIAL NEOPLASIA, SEBACEOUS GLANDS

INTRODUCTION: Extramammary Paget disease consists of a cutaneous adenocarcinoma in areas of apocrine glands. It is a rare neoplasia, and its surgical treatment yields satisfactory results. However, due to the high recurrence rates, surgeries are potentially disfiguring. Imiquimod is a topical immune-stimulant used for the treatment of anogenital warts and in situ carcinomas. Its use has been described in the scientific literature for the treatment of Extramammary Paget disease with satisfactory results.
OBJECTIVE: Describe the course of four cases of Extramammary Paget disease treated with imiquimod, to evaluate evolution and therapeutic response.
METHODS: A retrospective study was performed in a service of dermatology in the city of São Paulo, with the review of medical records of all patients diagnosed with Extramammary Paget disease and treated with imiquimod from January 2011 to July 2018.
RESULTS: Four patients were included, three with vulvar lesion and one with scrotal lesion. Two women presented completed resolution of the disease, one did not respond and the man progressed with 70% regression of the lesion, having undergone surgical excision of a considerably smaller area than the initial lesion.
CONCLUSIONS: Imiquimod presents as a valid therapeutic modality for the treatment of Extramammary Paget disease.

Keywords: Paget disease, extramammary; Neoadjuvant therapy; Gynecology; Urogenital neoplasms, female; Genital neoplasms, male; Neoplasm recurrence, local; Skin neoplasms; Therapeutics; Vulvar neoplasms;

O queratoacantoma (QA), apesar de frequente na prática diária, é um tumor que gera questionamentos. O aspecto mais intrigante associa-se à sua posição no limite entre malignidade e benignidade. A abordagem do tumor, bem como sua classificação, é controversa. Na definição da conduta, é importante levar em conta o potencial de transformação para carcinoma espinocelular. Desse modo, a excisão cirúrgica é a terapia de escolha, sempre que possível. Algumas situações merecem atenção adicional, como a imunossupressão associada. Neste artigo, relatamos um caso de QA gigante em um paciente com síndrome da imunodeficiência adquirida tratado com cirurgia micrográfica de Mohs.

Keywords: Ceratoacantoma; Retalhos Cirúrgicos; Neoplasias Nasais; Neoplasias Cutâneas; Cirurgia de Mohs; Síndrome de Imunodeficiência Adquirida; HIV; Imunossupressão

Sarcomas são neoplasias mesenquimais malignas, raras, que acometem, principalmente, crianças e adolescentes. O rabdomiossarcoma, subtipo oriundo da musculatura esquelética, é condição incomum em adultos, acometendo sítios de localização não habitual, crescimento rápido e de difícil tratamento. Apresenta-se caso de adulto jovem com nodulação em lóbulo auricular esquerdo, cuja análise histopatológica e imuno-histoquímica confirmou tratar-se de rabdomiossarcoma alveolar, o qual foi conduzido em conjunto com a Oncologia.

Keywords: Rabdomiossarcoma Alveolar; Miogenina; Desmina; Excisão de Linfonodo

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

The labia majora become saggy with aging. Although filling with hyaluronic acid provides significant rejuvenation, it can also lead to the formation of true vulvar testicles if poorly indicated, especially in excessively flaccid vulvas, which do not support any further volumization. In these cases of excessive flaccidity, we believe that collagen biostimulators would be the best initial treatment, as their injection would lead to the replacement of dermal collagen and improvement in laxity, without a significant increase in volume. We have been using calcium hydroxyapatite, l-polylactic acid, and PDO threads since 2019, with good results.

Keywords: Vulva; Collagen; Genitalia, Female; Rejuvenation

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

Extramammary Paget’s disease (EMPD) is a rare malignancy and is quite difficult to diagnose. We report a case of a 51-year-old female patient with perianal EMPD. Because experience with this disease is still very limited, we searched international databases for similar publications. After consultation with an oncologist, the treatment was wide excision without adjuvant therapy. This treatment option was curative.

Keywords: Paget Disease, Extramammary; Surgery, Plastic; Anal Gland Neoplasms.

Syringoma is a rare benign adnexal tumor of the intraepidermal eccrine duct of unknown etiology. It is typically characterized by multiple, bilateral, yellow-brownish or skin-colored papules measuring 1-5 mm. Syringomas predominantly affect the face but can also be found in gluteal, pubic, vulvar, or thoracic regions. In this article, we report two cases of vulvar papules with a confirmed diagnosis of syringoma by histopathological analysis, which were successfully treated with carbon dioxide (CO₂) laser therapy. The selected treatment approach was easy to implement and resulted in a favorable clinical response, including improvement of itching after the first session.

Keywords: Syringoma; Vulvar Diseases; Pruritus Vulvae; Adenoma; Sweat Gland; Lasers

Despite the therapeutic success described by recent studies, the procedure of labia majora augmentation lacked systematization in order to achieve more assertive and reproducible results. To this end, we developed the vulvar anatomical vector technique, in which we mapped five anatomical structures of the vulva where the injection of hyaluronic acid is capable of promoting coaptation, augmentation, reduction of prolapse, and/or improvement of the skin quality of the labia majora. This technique has allowed us to precisely define the sites to be injected and estimate the adequate volume and type of hyaluronic acid to achieve the intended results.

Keywords: Hyaluronic Acid; Vulva; Dermal Fillers; Rejuvenation; Female Genitalia.

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