We report the case of a patient presenting a 3 cm diameter ulcerated nodular basal cell carcinoma in the frontal left region, reaching the medial half of the eyebrow. The lesion was excised and the reconstruction was carried out with advancement fl aps in H and the left included the rest of the eyebrow, being larger than the contralateral. Thus, the harmony and symmetry of the superciliary and glabellar regions were remained. The scars were visible just by being positioned in wrinkles rows. The patient remains without injuries after two years of monitoring.

Keywords: CARCINOMA, BASAL CELL, CUTANEOUS ONCOLOGY, DERMATOLOGY SURGERY

Introduction: Skin cancer is the most common type of neoplasia in humans, with ultraviolet radiation being considered the main cause. Basal cell carcinoma is the most frequent cutaneous neoplasia, and photoprotection is seen as the most effective measure in its prevention. Nonetheless, there is still some resistance to the use of sunscreens among the general population. There is also a lack of reports in the literature on whether such resistance differs in patients with basal cell carcinoma. Objectives: To evaluate whether there is change in habits regarding exposure to the sun and use of sunscreen after diagnosis of basal cell carcinoma in patients treated at the Dermatology Outpatient Clinic of Universidade Federal de Ciências da Saúde de Porto Alegre (RS), Brazil. Methods: A cross-sectional study was carried out with 120 patients diagnosed and treated for basal cell carcinoma, who responded to a questionnaire regarding their sun exposure habits and use of photoprotection methods before and after diagnosis. Results: Of the 120 patients interviewed, 73.3% reported changes in their habits regarding exposure to the sun and use of sunscreen after receiving a diagnosis of basal cell carcinoma. The main reasons alleged by those who denied having changed their behavior towards sun exposure (26.7%), were the lack of fear of new tumors, as well as the high cost of sunscreens. Conclusions: A diagnosis of basal cell carcinoma motivates most patients to improve their use of preventive measures regarding protection from the sun. Nonetheless, about a third of the studied population still resisted such measures, the main reason cited being the high cost of sunscreens. Therefore, awareness campaigns about the importance of using photoprotection methods to prevent skin cancer must be implemented, and the development of programs aimed at making sunscreens available to the general population – especially to high-risk patients – must be sought.

Keywords: SKIN NEOPLASMS, CARCINOMA, BASAL CELL, HEALTH EDUCATION

The reconstruction of defects resulting from tumor resection is a challenge for the surgeon, who should get good results both functional and aesthetic. The objective of the present study is to describe the surgical technique used in a 78-year-old male patient with the diagnosis of squamous cell carcinoma in the lower lip and who underwent excision of the lesion and reconstruction with the Karapandzic technique. This flap is employed in the reconstruction of surgical defects that cover 40-75% of the lip's extension.

Keywords: CARCINOMA, SQUAMOUS CELL, SURGICAL FLAPS, LIP NEOPLASMS.

The authors present the surgical reconstruction after excision of two synchronous adjacent basal cell carcinomas in the left infraclavicular region, using the Zetaplasty transposition flap technique. Being versatile and simple to perform, Zetaplasty was proven a useful solution for the reconstruction of double defects within a single procedure.

Keywords: CARCINOMA, BASAL CELL; SKIN NEOPLASMS; SURGICAL FLAPS

Ultrasonography is a diagnostic imaging method, which is painless and non-radioactive, and based on the reflection of sound waves through the tissue. The recent development of high frequency and better resolution equipment has enabled the observation of superficial structures and the identification of the different layers, structures, and appendages of the skin, considerably increasing its use in various dermatological conditions - particularly in skin cancer. The authors present two cases in which the association of dermoscopic and ultrasound examinations allowed the careful in vivo analysis of tumor morphology, contents, size, thickness and vascularization, allowing the differentiation between basal cell carcinoma and hidrocystoma, and thus contributing to better pre-operative assessment.

Keywords: CARCINOMA, BASAL CELL; HIDROCYSTOMA; NEOPLASMS; ULTRASONICS

Basal cell carcinoma is the most common type of cancer and its non-surgical treatment has been the subject of many studies. Large lesions of this tumor are therapeutic challenges and the effective topical treatment has good applicability. The authors present a female patient diagnosed with multicentric superficial basal cell carcinoma in the lumbar region for more than 20 years, who refused to be treated surgically. The tumor reached dimensions of 12 cm x 10 cm. A decision was made for a non-surgical therapy, with the application of Imiquimod in a treatment of 5 weekly applications for 2 months. The treatment led to a clinical and histological cure, without recurrence to date (36 months), with excellent aesthetic results and few side effects.

Keywords: CARCINOMA, BASAL CELL; THERAPEUTICS; NEOPLASMS

Basal cell carcinoma is the most frequent malignant skin tumor. Its incidence has been increasing, leading to the emergence of a public health problem. The common delay in seeking treatment hampers tumor removal. The objective of this paper was to report a case of two synchronous basal cell carcinomas on the face and the challenge of their surgical resolution. Good aesthetic and functional outcomes were obtained using the rotation flap technique and a complex reconstruction of the hemiface. Surgical reconstruction constitutes a challenge for the surgeon, who should prioritize the oncologic cure while preserving the functionality and aesthetic appearance, when possible.

Keywords: CARCINOMA, BASAL CELL; SURGICAL FLAPS; SKIN NEOPLASMS

Basal cell carcinoma corresponds to the majority of malignant cutaneous malignancies in Brazil, predominating in middle-aged white individuals, mainly affecting the upper two-thirds of the face and occurring due to several etiological factors. The ideal treatment consists of complete removal with free lesion margins. For better functional and aesthetic results, reconstruction of the surgical wound with flaps or grafts may be necessary. Two types of reconstruction are described in patients with double surgical defects on the face, close to each other: one with a single rotation flap and another with a double rotation flap, also called Yin-Yang.

Keywords: SKIN NEOPLASMS; CARCINOMA, BASAL CELL; SURGICAL FLAPS

The cutaneous field cancerization corresponds to an area of skin chronically exposed to the sun. It contains actinic keratoses and other skin signs of photodamage caused by ultraviolet radiation. This field comprises the genetic alterations that form the basis of the process of cutaneous carcinogenesis. Actinic keratoses have the potential to be stable for years, to regress spontaneously or to become invasive carcinomas. There is a consensus in the literature that the treatment of the entire field cancerization is more effective than treating just isolated lesions since it is not possible to predict which of these lesions will evolve to invasive cancer. It is also effective in the prophylaxis and treatment of the existing clinically imperceptible incipient lesions. There are several therapeutic options for individualized actinic keratoses and the field cancerization, from self-applied topical drug therapies to interventional and surgical therapies.

Keywords: Actinic keratoses; Skin cancerization field; cutaneous carcinogenesis; squamous cell carcinoma

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 (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

The lower eyelid is one of the sites most affected by basal cell carcinoma (BCC). We present an option of inner corner skin flap with oral mucosa graft for eyelid reconstruction after BCC excision. This tumor affects approximately 60% of the lower eyelid and shows complete lower lacrimal canaliculus involvement. The use of internal corner skin transposition flap and oral mucosa graft is safe. The technique is reproducible and with good postoperative evolution. Positioning and eyelid movement were restored, allowing tear drainage through the upper canaliculus with complete correction of the tears’ overflow (epiphora).

Keywords: Basal cell carcinoma; Skin Neoplasms; Dermatological Surgical Procedures; Surgical Flaps

The recurrent squamous cell carcinoma (SCC) needs an appropriate approach to decrease the risk of recurrences. We report the case of a man diagnosed with SCC on the left temporal region treated by conventional surgery, with infiltration and erythema in the scar area. Reflectance confocal microscopy suggested the diagnosis of recurrent SCC confirmed by histopathology. New surgery and traditional intraoperative frozen section were performed. After two months, the patient had a new relapse, finally treated with Micrographic surgery without new involvement. This article highlights the importance of micrographic surgery in treating SCC, aiming to decrease new recurrences.

Keywords: Skin Neoplasms; Mohs Surgery; Carcinoma, Squamous Cell

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

INTRODUCTION: The advent of squamous cell carcinomas (SCC) from chronic dermatoses is known but little explored. Although rare, tumors originating there have a worse prognosis, in part due to late diagnosis.
OBJECTIVES: This study aims to survey cases of squamous cell carcinoma developed on previous dermatoses diagnosed between 2000 and 2020 in a tertiary health service.
METHODS: This is a quantitative and retrospective study through biopsy reports survey and medical records review.
RESULTS: From an initial list of 11,249 histological reports compatible with squamous cell carcinoma, we obtained a final list of 10 patients. The study findings corroborate the literature regarding some known risk factors: abundant and chronic sun exposure, older than 50 years, lower skin phototypes, and immunosuppression. We also found a high frequency of smoking and lichenoid dermatoses (5/10 patients) in the studied population, including chronic cutaneous lupus erythematosus and hypertrophic lichen planus.
CONCLUSIONS: It is not possible to predict the primary risk factors for the development of squamous cell carcinomas regarding previous dermatoses, although there is a tendency for their appearance in lichenoid dermatoses and those with longer evolution.

Keywords: Skin diseases; Squamous cell carcinoma; Lupus erythematosus, Cutaneous; Lichen planus