The partial regression of cutaneous melanoma is a frequent event. Nevertheless, complete regression is a rare and difficult to diagnose condition.We report three cases of regressed cutaneous melanoma (RCM) whose initial biopsies did not reveal melanoma and in which the diagnosis was based on the presence of metastasis. There is no consensus about the prognosis of RCMs. Some authors relate a higher prevalence of metastasis, coinciding with our cases'''''''' outcomes, where the RCM had the worst prognosis due to the tumors'''''''' aggressiveness or to the difficulty in establishing an early diagnosis and staging. We have concluded that the regression of melanoma complicates the diagnosis, staging and formulation of a worst-case scenario prognosis. Excisional biopsy should always be the first choice.

Keywords: MELANOMA, NEOPLASM REGRESSION, SPONTANEOUS, NEOPLASM METASTASIS, PROGNOSIS

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

Introduction: Cutaneous melanoma has significant relevance among malignant skin tumors, for despite its low incidence (3-4%) it is associated with the highest mortality. In Brazil, estimates for the year 2014 correspond to 10% of all cancers, establishing this as an important public health issue. Objectives: To present epidemiological data related to melanoma skin cancer in the midlands of the Brazilian State of São Paulo. Methods: Descriptive retrospective cross-sectional analysis of data from a tertiary hospital's medical records. The analysis was subject to measurement and information bias. A descriptive analysis with frequency and percentage was carried out. Results: There was a prevalence of cutaneous melanoma in women (71%), patients between 50 and 70 years of age (56%), Caucasians (78%), and individuals who identified their lesions through self-examination (42%), with predominant involvement of the trunk (35%). The most prevalent histological subtype was the superficial spreading (58%). Conclusions: Understanding the epidemiology of cutaneous melanoma in a given geographic region enables and facilitates medical actions, allowing for the better establishment of strategies for primary and secondary prevention.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

The present article discusses the importance of differential diagnosis with lesions located in the umbilicus. A case of verrucous nevus is described in this location, emphasizing the role of dermoscopy in the diagnosis.

Keywords: MELANOMA, EPIDEMIOLOGY, SKIN NEOPLASMS.

Introduction: The trends of malignant melanoma in Brazil are aligned with those worldwide: increasing incidence with reduced degree of severity at diagnosis. Objective: To use the prognostic criteria of the Grupo Multicêntrico e Multidisciplinar Brasileiro para Estudo do Melanoma (Brazilian Multicenter and Multidisciplinary Group for the Study of Melanoma) combined with clinical characteristics aimed at developing a clinical and histopathological profile of melanoma cases. Methods: A cross-sectional descriptive study was carried out, with the retrospective analysis of medical records of patients diagnosed with melanoma at a tertiary dermatology reference unit in the city of Bauru, in the Brazilian southeast State of São Paulo, between January 2007 and July 2014. Results: Female patients accounted for 56.2%, with ages ranging from 27 to 95 years (Mean = 61.4 years), with a lesion having been detected on physical examination in 36% of cases. The highest incidence of the disease was in the lower limbs (23.5%), with the superficial spreading subtype corresponding to 79.6% of biopsies. The average Breslow thickness was 2.9 mm, and in 28.1% of cases, the lesion was in situ. Conclusions: The following profile emerged: women, 61-years-old, with lesions in the lower limbs, superficial spreading subtype and with evidence of good prognostic. Studies like this are important due to the fact they provide subsidies for the design of strategies to treat the population.

Keywords: EPIDEMIOLOGY; MELANOMA; HISTOLOGY; PATHOLOGY, SURGICAL; SKIN NEOPLASMS

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

Cutaneous metastases of internal malignancy are rare, and their incidence ranges from 0.7 to 9% among all cancers. They account for 2% of all skin tumors. They occur due to the growth of cancer cells in the dermis or subcutaneous cellular tissue, originating from internal neoplasia. Cutaneous metastasis arising from squamous cell carcinoma of the esophagus is rare, accounting for less than 1% of cases. We report a case of squamous cell carcinoma of the esophagus diagnosed after metastatic cutaneous manifestation in the abdomen that evolved to death due to disseminated metastatic tumor invasion.

Keywords: CARCINOMA, SQUAMOUS CELL; SKIN SEOPLASMS; NEOPLASM METASTASIS

Complete surgical removal of lentigo maligna is challenging due to the difficulty in determining margins, subclinical spread and frequent facial location. In this article, we report the surgical approach of an extensive facial lentigo maligna with the "spaghetti" technique, with free margins in the third surgical step. This technique consists in the resection of a circular margin surrounding the clinical boundaries of the tumor, with histological evaluation, without removing the lesion. New steps include widening of the affected margins until the whole area is free, when tumor resection and reconstruction of the surgical defect take place simultaneously. The aim is to reach the free margins, preserving tissue in aesthetic and functional areas.

Keywords: Bloodless medical and surgical procedures; Melanoma; Skin neoplasms

Malignant melanoma is a melanocyte tumor responsible for more than 75% of skin cancer deaths. The rare variants of this pathology are responsible for 5% of the cases and may mimic other pathologies. We report the case of a patient with spitzoid melanoma and we discuss the dermoscopic, histopathological, and immunohistochemical findings, as well as the follow-up of this rare variant of melanoma.

Keywords: Melanoma; Nevus, epithelioid and spindle cell; Melanoma-specific antigens; Skin neoplasms; Dermoscopy

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

Acral amelanotic melanoma is rare and can mimic many entities, such as eccrine poroma, squamous cell carcinoma, plantar wart, and chronic ulcers. Due to the variety of possible differential diagnoses, it is a challenging and frequently late diagnosis. Dermoscopy features can help in early diagnosis. The dermatologist should keep this diagnosis in mind when faced with a pink, progressively growing, irregularly shaped lesion, mainly if located on the hands and feet.

Keywords: Dermoscopy; Melanoma amelanotic; Skin neoplasms; Oncology; Foot ulcer

INTRODUCTION: Skin cancer is one of the most prevalent neoplasms, and melanoma is its most aggressive form. It is responsible for most deaths due to its high metastatic potential. The early diagnosis affects the patients’ prognosis and can be encouraged by educating the population regarding self-examination of the skin and recognition of salient characteristics of the lesions.
OBJECTIVES: To evaluate the impact of an educational video intervention on skin cancer with the application of a questionnaire before and after the intervention.
METHODS:Prospective quasi-experimental study that included patients assisted in the dermatology service of a public hospital in Belo Horizonte.
RESULTS: 196 patients were included. Although most participants recognized the importance of monitoring with a dermatologist (81.1%), most were unaware of melanoma (70.9%). There was a significant change in knowledge about skin neoplasms, especially regarding the ABCDE mnemonic (P<0.01).
CONCLUSIONS: The educational intervention contributed to increasing significantly the participants’ knowledge about skin cancer. With the contact restrictions imposed by the COVID-19 pandemic, actions that disseminate information and encourage self-examination of the skin become even more essential for early diagnosis.

Keywords: Knowledge; Dermatology; Education; Melanoma; Skin neoplasms

Cutaneous angiosarcoma is a rare cancer with a poor prognosis that affects mainly elderly men. It is related to chronic exposure to sunlight, chronic lymphedema, and procedures using radiation. We report a case of a 62-year-old man with a progressively growing violaceous tumor in the left temporal region. Dermoscopy showed erythematous areas of different shades, pseudo-follicular openings structures, and rosettes. The biopsy and the immunohistochemical study confirmed the diagnosis of cutaneous angiosarcoma. The patient is currently undergoing chemotherapy treatment in the oncology service with significant improvement of the lesion.

Keywords: Dermoscopy; Hemangiosarcoma; Skin neoplasms

INTRODUCTION: Melanoma comprises 3% of all skin tumors and can produce metastasis with high mortality.
OBJECTIVE: To analyze the temporal behavior of mortality from skin melanoma in the capitals of Northeast Brazil from 2001 to 2017.
METHODS: We conducted an ecological time series study involving all deaths due to melanoma registered in the capitals of the Northeast region of Brazil from 2001 to 2017. Crude and standardized rates by the world and Brazilian populations were analyzed. We obtained the indicators from the National Cancer Institute (INCA). The regression model by inflection points was used in the statistical analysis, calculating the annual variation and the average annual variation percentages.
RESULTS: There were 954 deaths from melanoma. The three rates analyzed showed a linear growth trend over the time series: proportional mortality increased from 2.1% to 8.28% (AAPC 6.0%; p<0.02), the crude mortality grew from 0.22 to 0.64/100 thousand (AAPC 5.0%; p<0.01) and the mortality adjusted by the world population in the capitals of the Northeast rose from 0.28 to 0.61/100 thousand (AAPC 2.7%; p<0.01).
CONCLUSION: Mortality from melanoma grew in the Northeastern capitals, with inequality between the sexes and according to the capitals.

Keywords: Epidemiology; Melanoma; Mortality; Skin neoplasms.

Mohs micrographic surgery, created in 1930 by Frederich Mohs, is a world-renowned technique to treat skin cancers. Currently, it is used to treat basal cell and squamous cell carcinomas, ensuring excellent cure rates for patients. However, regarding the treatment of cutaneous melanoma, the use of Mohs surgery is not a consensus among specialists. This article aims to elucidate whether Mohs surgery is a safe and effective treatment for melanoma skin cancer.

Keywords: Melanoma; Mohs Surgery; Skin neoplasms; Treatment Outcome; Prognosis.