Dermatoscopy can be used in the pre-operative analysis of melanocytic and non-melanocytic tumors.The effectiveness of this technique can be demonstrated in the selection of the best site for carrying out excisional biopsies, in the delimitation of tumoral margins, in the pre-operative estimation of tumoral thickness of melanomas, and in the screening of recurrences.

Keywords: DERMOSCOPY, SURGERY, DERMATOLOGY, MELANOMA

Seborrheic keratosis are benign epithelial tumors that are usually easily diagnosed through clinical and dermatoscopic examination. They can sometimes resemble malignant lesions, especially melanoma. This article illustrates two such cases, highlighting the detailed dermatoscopic observations that help distinguish these lesions, to help increase the accuracy of diagnoses.

Keywords: KERATOSIS, SEBORRHEIC, MELANOMA, DERMOSCOPY

Cutaneous melanoma’s prognoses depend primarily on the tumor’s thickness; early detection of melanomas is extremely important to increase a patient’s chances of survival. The use of dermatoscopy can be up to 90% accurate. Changes in pigmented lesions may occurduring pregnancy, however the challenge lies in knowing whether such changes are benign or whether they indicate a melanoma. Dermatoscopy is an important diagnostic tool that increases the accuracy of detection and diagnosis of the margins of melanomas in their earliest stages, which consequently improves patients’ prognosis and survival rates.

Keywords: PREGNANCY, MELANOMA, DERMOSCOPY

Introduction: One of the most challenging dermoscopic situations is to distinguish between early melanomas and doubtful benign nevi. At times, suspicious melanocytic lesions have dermoscopic features similar to melanomas, thus leading to excessive excisions of lesions.
Objective: To develop a dermoscopic model that helps to differentiate the doubtful nevus from the early melanoma.
Material and methods: A total of 219 histopathologically confirmed dermoscopic images were analyzed and a comparison between doubtful nevi and early melanomas was then performed.
Results: The final model was based on three dermoscopic features: radial streaming, blue hue and vascular structures. If all three features were absent, it was most likely a nevus; if one dermoscopic feature was present, it could be a nevus or melanoma; if two features were present, there was a greater probability of melanoma diagnosis; if three features were present, it was melanoma.

Keywords: DERMOSCOPY, MELANOMA, NEVUS, PIGMENTED

First described in 1971 by Conley and colleagues, desmoplastic melanomas represent less than 4% of cutaneous melanomas. It is a distinctive and uncommon variant characterized by a spindle cell fibrous tumor of collagen forming cells, isolated by dense fibrous matrix. Desmoplastic melanomas are frequently misdiagnosed, mainly due to their similarity to other fibrous neoplasms. A review of about 600 reported cases unexpectedly revealed the pigmented clinical presentation of a deep and fibrous nodule that is classically associated with a precursor lesion. The ability to recognise this lesion’s characteristics is very important, due to its recurrent behaviour and subsequent need for a specialized surgical approach.

Keywords: MELANOMA, NEOPLASM RECURRENCE, LOCAL, GP100 MELANOMA ANTIGEN, MELANOMA-SPECIFIC ANTIGENS

This article describes the case of a 62-year-old patient who developed an erosive nodular mass on the nail apparatus after receiving a trauma during a hunting incident. The lesion was initially diagnosed as an amelanotic melanoma of the nail apparatus, illustrating the fact that this type of lesion is often misdiagnosed – up to 85% of the time if the physician lacks dermatological expertise –and remains untreated for prolonged periods.

Keywords: MELANOMA, MELANOMA, AMELANOTIC, WOUNDS AND INJURIES

Fordyce granules are referred to as benign ectopic sebaceous glands characterized by multiple yellow papules, occurring mainly in the lower lip. It is mainly observed in adult men. The present study describes two cases of patients with Fordyce granules who were treated using a CO2 laser and obtained good cosmetic results.

Keywords: MOUTH MUCOSA, LASER THERAPY, CARBON DIOXIDE

Over the last centuries, several surgeries for eyelid reconstruction have been developed, perhaps due to the complexity of this anatomical area. Tumors larger than two-thirds of the lower eyelid preclude their direct closure and require surgical reconstruction that preserves the anatomy of the eyelid. The purpose of the present study is to present a technique for reconstruction of the lower eyelid with jugal mucosa and Mustardé flap or advancement flap, without reconstruction of the tarsus. This technique was performed in a series of six cases, all presenting satisfactory post-operative results. These patients did not present distortion of the anatomy nor ectropion.

Keywords: CARCINOMA, BASAL CELL; CARCINOMA, SQUAMOUS CELL; MOUTH MUCOSA; EYELID NEOPLASMS; SURGICAL FLAPS.

A Wood's lamp is a cost effective, safe, easy to use diagnostic tool that is readily available at medical practices. However, its dermatological application has been restricted to the detection of cutaneous infections, the evaluation and classification of pigmentation disorders (such as melasma and vitiligo), and the analysis of disturbances in the metabolism of porphyrins. In the present report the authors demonstrate the use of a Wood's lamp as an alternative to confocal optical microscopy, in the delimitation of the surgical margins of a hypomelanotic lentigo maligna melanoma, whose lack of melanin pigmentation and tumor location in a photodamaged area had hampered a patient's surgical planning.

Keywords: LIGHT; MELANOMA; MELANOMA, AMELANOTIC; MICROSCOPY, CONFOCAL;

The upper lip is commonly affected by cutaneous carcinomas. The excision of the neoplasia with safe oncologic margins calls for a large incision, and sometimes flaps are necessary. In addition to its aesthetic value, a successful lip reconstruction includes the maintenance of perfect oral functionality. The authors describe a nasolabial rotation cutaneous flap associated with an advancement flap of the oral mucosa in a single surgical event, performed on a patient bearing basal cell carcinoma involving the left side portion of the upper lip.

Keywords: SURGICAL FLAPS; CARCINOMA, BASAL CELL; MOUTH MUCOSA

Tumoral melanosis is a histological term used to refer to a nodular accumulation of melanophages in the dermis, which clinically arises as a pigmented lesion. It is usually associated with the regression of melanomas or of other melanocytic lesions. The authors present the case of a 45-year old man/woman with a pigmented macule on his/her left leg. The lesion was completely excised and diagnosed as a tumoral melanosis.

Keywords: MELANOMA; SKIN NEOPLASMS; DERMATOSCOPY

Diagnosing basal cell carcinomas, both clinically and dermoscopically, is part of most dermatologists' daily routine. However, tumors of this lineage, when densely pigmented, can be a challenge for the physician and surgeon. Dermoscopic features typical of melanocytic lesions may be present in these carcinomas, and the similarity with melanoma results in a real dilemma. More in-depth knowledge on this topic can make a difference in the management of these cases.

Keywords: Carcinoma, Basal cell; Dermoscopia; Diagnosis; Melanoma

The nevus spilus (NS), also known as speckled lentiginous nevus or nevus on nevus, is represented by a brownish macule on which small macules of darker shades appear. It is more common on the trunk and lower limbs. The general population's prevalence is 0.2% to 2.3%, and they have a benign character. The exact risk for malignant transformation is still unknown; thus, it demands a routine clinical-dermoscopic follow-up. We present a case of malignant melanoma on acquired nevus spilus, in which early an excision was performed, with no recurrence, highlighting the importance of follow-up of these patients.

Keywords: Melanoma; Nevi and melanomas; Nevus

Patients with giant congenital melanocytic nevus are at higher risk of developing melanoma. After the first diagnosis of melanoma, there is also a higher incidence of subsequent melanomas in the same patient. However, the ideal therapy for this type of nevus is still controversial. We report the case of a patient with giant congenital nevus associated with multiple synchronous melanomas and the proposed treatment.

Keywords: Melanoma; Nevi and melanomas; Neoplasms

Oral mucosa melanoma (OMM) represents 0.2% to 8% of melanoma cases. It mainly affects the palate and gums of patients between 40 and 70 years old. It is initially asymptomatic, contributing to late diagnosis and poor prognosis. The treatment of choice consists of surgical resection, and adjuvant radiotherapy and chemotherapy may be used. We report a case in an 80-year-old male patient with primary gingival and hard palate melanoma who underwent tumor resection followed by palate reconstruction. We emphasize the importance of a complete physical examination and active search for lesions in the oral mucosa for early diagnosis.

Keywords: Melanoma; Mouth mucosa; Palate