Introduction: Mohs Micrographic Surgery is a well-known and established method in the United States, and is currently considered the gold standard treatment in many cases involving cutaneous neoplasias. Since it was first described by Dr. Frederic E. Mohs, the micrographic surgery technique has been continuously changed and adapted to better suit the daily life needs of dermatologic surgeons. This article examines different and innovative Mohs Micrographic Surgery techniques.

Keywords: MOHS SURGERY, CARCINOMA, BASAL CELL, CARCINOMA, SQUAMOUS CELL

Introduction: Dermatoscopy can help practitioners analyze details that are imperceptible to the naked eye, such as basal cell carcinoma arboriform vascularization patterns, which can b e linked to the tumoral limit. Clinical examinations might yet fail in the early detection and demarcation of the extension of such lesions.
Objective: To study the use of dermatoscopy in basal cell carcinomas, aiming at early detection and delimitation of their extension. Method: Basal cell carcinomas (n = 123) were studied prospectively and not randomly, using dermatoscopy, at the author''''''''s private practice. Suspect areas, mainly the nose, underwent dermatoscopic scanning. If the vascular pattern was identified, the tumor was delimited by dermatoscopy, and the incision was carried out using that marking. Surgical margins were checked using conventional cuts, cross sections or micrographic surgery.
Results:The vast majority of the tumors (92%) were located in the face, of which 59% were not well delimited, 21% were well delimited, and 20% were clinically undetectable. Although the vascular pattern was not observed in 18% of the tumors, in cases with a positive identification, it correctly delimited the tumors in 84% of cases (of which 44% were verified with conventional sampling, 48% with micrographic surgery and 8% with cross sections).
Conclusion: Dermatoscopy is an important tool in the early detection and delimitation of the superficial extension of basal cell carcinomas, and is helpful in the surgical planning and clinical control of such lesions.

Keywords: DERMOSCOPY, CARCINOMA, BASAL CELL, MOHS SURGERY, BLOOD VESSELS, CAPILLARIES

A case of pigmented basocellular carcinoma clinically mimicking a malignant lentigo melanoma in the temporal region of a black female patient is reported. Basal cell carcinoma rarely occurs in black patients. When present, however, it is the second most common malignant skin neoplasia, and is usually pigmented. When the face is affected in such patients, it is difficult to differentiate between malignant lentigo melanoma and basal cell carcinoma. Dermatoscopy is a very helpful diagnostic tool in these cases.

Keywords: CARCINOMA, BASAL CELL, MELANOMA, DERMOSCOPY

Dermoscopy is increasingly used to diagnose non-melanocytic skin tumors. Basal cell carcinoma presents some highly suggestive structures for its diagnosis. The presence of chrysalides-like structures is also frequently found in other benign and malignant skin tumors, and their significance in basal cell carcinoma has yet to be determined. HPV is a virus with oncogenic potential and its involvement in the pathogenesis of basal cell carcinomas is also not yet clearly understood.

Keywords: CARCINOMA, BASAL CELL, DERMOSCOPY, ONCOGENES

Solitary pink lesions of the face may have nonspecific dermoscopic patterns, and are thus deemed difficult to diagnose. Differential diagnoses to consider are: actinic keratosis, squamous cell carcinoma, basal cell carcinoma, and amelanotic melanoma. Confocal microscopy can be used as an auxiliary clinical examination in their diagnosis and in determining the most significant sites for carrying out a biopsy. The authors describe a case that illustrates the usefulness of a confocal microscopy examination in pink lesions.

Keywords: DERMOSCOPY, MICROSCOPY, CONFOCAL, CARCINOMA, BASAL CELL, KERATOSIS ACTINIC

We report a case of pigmented Bowen's disease in the periungual region treated with Mohs micrographic surgery. Bowen's disease is a squamous cell carcinoma in situ. Although it is a common condition, the pigmented form is rarer, with periungual localization being even more uncommon. Pigmented Bowen's disease presents clinically as a non-uniform, desquamous or verrucous brownish lesion, and it is often confused with other diseases (pigmented actinic keratosis, seborrheic keratosis, melanoma, basal cell carcinoma, nevus). Dermoscopy is of great diagnostic and therapeutic value and is important in the evaluation of recurrence.

Keywords: BOWEN'S DISEASE; CARCINOMA, SQUAMOUS CELL; DERMOSCOPY

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 cuniculatum carcinoma is a rare, slow-growth, local aggressive subtype of the squamous cell carcinoma, presented as a verrucous lesion with a low metastasis capacity. Its histopathology shows keratin-filled crypts, and its etiology is linked with HPV, especially 11 and 16 subtypes. The treatment of choice is surgical excision, followed by regular monitoring due to the high risk of local recurrence. We report a case of a woman with Cuniculatum carcinoma treated with surgery with perioperative frozen section procedure, graft, and good evolution.

Keywords: Carcinoma; Carcinoma, Squamous Cell; Foot

Basal cell carcinoma over the tattoo region has been poorly reported in the literature, with a total of 13 cases. All cases describe the clinical aspect of the lesion and its pathogenesis but do not characterize the dermoscopy. We report two cases of basal cell carcinoma on tattoos with clinical and dermoscopy features, treated with Mohs micrographic surgery. It was challenging to establish the tumor’s clinical and dermoscopic margins due to the tattoo’s exogenous pigment.

Keywords: Carcinoma, Basal cell; Dermoscopy; Tattooing; Mohs surgery

INTRODUCTION: Basal cell carcinoma is the most common non-melanoma malignancy in humans. Its superficial variant has specificities that can represent a diagnostic and therapeutic challenge.
OBJECTIVE: To describe the epidemiological profile of patients with superficial basal cell carcinoma (SBCC) treated at a reference service and to correlate, statistically, clinical, dermoscopic, and anatomopathological characteristics.
METHODS: Observational, analytical, cross-sectional study conducted by collecting data from patients with suspected SBCC between November 2019 and October 2020.
RESULTS: In total, we confirmed 25 lesions as SBCC. They were more frequent in women, in the head and neck, and with a diameter of less than 1 cm. We also observed, in clinical characteristics, a predominance of individuals over 60 years old and with phototypes II and III. The anatomopathological examination observed some pigmentation in the lesions evaluated and a predominance of intra-epidermal keratinocytes in lesions with maple leaf-like areas in dermoscopy.
CONCLUSIONS: SBCC can present clinically as a pigmented lesion, affecting more the head and neck regions. Lighter skin phototypes are more likely to have SBCC with pigmented dermoscopic structures. Intra-epidermal keratinocytes possibly correlate with the formation of maple leaf structures.

Keywords: Basal cell carcinoma; Dermoscopy; Epidemiology; Skin Neoplasms; Pathology

Basal cell carcinoma (BCC) is more common in the lower eyelid region when it affects the periorbital region. It occurs predominantly in men between 50-70 years and has a high recurrence rate. Although it rarely metastasizes, orbital invasion can occur. This study aims to present a case of pigmented BCC of unusual location. The location of BCC in the upper eyelid region is rare, and dermoscopy is essential to distinguish it from its primary differential diagnoses.

Keywords: Basal cell carcinoma; Dermoscopy; Eyelid 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

INTRODUCTION: Seborrheic keratosis (SK) has the typical pigmented dermoscopy features such as fissures and ridges, fat fingers, and cerebriform patterns. Here we describe a case where pigmented columns (PC) were visualized on SK’s dermoscopy associated with a squamous cell carcinoma (SCC). Case presentation: We report a case of a lesion whose dermoscopy showed PC. Histopathological report showed well-differentiated SCC and associated SK. Discussion: The PC was visualized in an area of dendritic melanocytes in the epidermis, correlating with the pigmented SK component of the lesion. To our knowledge, this is the first time PC is described in SK´s dermoscopy.

Keywords: Carcinoma squamous cell; Dermoscopy; Skin neoplasms.

The globular dermoscopic pattern in pigmented lesions of basal cell carcinoma can cause diagnostic confusion, especially in cases in which other more commonly observed structures are absent. Therefore, the use of refletance confocal microscopy becomes important to determine the diagnosis and eliminate the need for biopsies.

Keywords: Carcinoma, Basal Cell; Dermoscopy; Microscopy, Confocal.