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 female hepatitis C patient who presented with a foreign body granuloma in the nasolabial folds and glabella five years after receiving an application of permanent dermal filler. The patient used interferon and ribavirin for treating hepatitis C for six months, and the granulomas appeared 30 days after the end of the treatment. Treatment with oral steroids was carried out, with a gradual improvement in the appearance of the skin.

Keywords: GRANULOMA, POLYMETHYL METHACRYLATE, FACE

Pyogenic granuloma is a common vascular proliferation that can be found on skin and mucous membranes. Its clinical presentation is that of a nodular, friable and erythematous lesion, with fast growth history. The nail bed pyogenic granuloma is generally related to onychocryptosis and trauma, being very painful in that site. There are several treatment options, including surgical excision, cryotherapy, electrocautery, curettage, lasers, application of trichloroacetic acid, imiquimod and microembolization. The present study reports a case of bilateral pyogenic granuloma in the halluces with exuberant growth, leading to the occlusion of the nail plate. The surgical excision of the lesion was performed with good cosmetic results.

Keywords: PYOGENIC GRANULOMA, SURGERY, TRICHLOROACETC ACID, CRYOTHERAPY.

p>Pyogenic granuloma is a common, benign, vascular proliferation, usually secondary to other events, such as cutaneous trauma. It is known that some lesions can mimic melanoma and vice versa, and it is recommended that the lesion be surgically removed and analyzed histologically. The advent of technologies-such as dermoscopy-that amplify the image recognized by the eye through the identification of certain structures and specific patterns, can facilitate this differentiation and assist in decision-making. In rare situations, its clinical presentation is unusual. The current article is aimed at demonstrating this fact and reviewing the medical literature on the subject, focusing on dermoscopic findings.

Keywords: PYOGENIC GRANULOMA, DERMOSCOPY, MELANOMA.

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

Description of a case where a female patient who received facial filling with polymethylmethacrylate developed late formation of a nodule and ipsilateral trigeminal neuralgia. The authors question whether there is a possible link between the two morbidities, which could have a common triggering factor or a causal relationship with each other.

Keywords: GRANULOMA; POLYMETHYLMETHACRYLATE; TRIGEMINAL NEURALGIA

Introduction: Mohs micrographic surgery is a technique that offers high cure rates for non-melanoma skin cancer.
Objective: To describe the clinical and epidemiological profile of patients who underwent Mohs micrographic surgery in a reference center in dermatologic surgery.
Methods: Medical records of patients who underwent Mohs micrographic surgery in the period 2014-2015 at a dermatology reference center, in the city of Mogi das Cruzes (SP, Brazil), were analyzed.
Results: The patients' ages ranged from 38 to 87 years; of these 54% were women. The most affected topography was the nose (54% of patients). Previous history of skin cancer was positive in 62% of cases. The indication driver for micrographic surgery was the lesion's location in 67% of the patients, followed by the size (23%) and tumor recurrence (10%). The most prevalent intraoperative diagnosis was basal cell carcinoma (90%).
Conclusions: Mohs micrographic surgery is an excellent therapeutic option in cases of tumors of aggressive nature, large diameter and high-risk location. This study is in line with the current literature regarding the epidemiological data linked to the occurrence of nonmelanoma skin cancer.

Keywords: MOHS SURGERY; SKIN NEOPLASMS; DERMATOLOGIC SURGICAL PROCEDURES

Case report of a 16-year-old female patient with diagnosis of subungual exostosis in the right hallux with clinical and histopathological diagnosis, submitted to total excision of the lesion and follow-up for five years with excellent aesthetic result.

Keywords: EXOSTOSES; BONE NEOPLASMS; DERMATOLOGIC SURGICAL PROCEDURES

Sarcoidosis is a non-infectious granulomatous disease of unknown etiology in which environmental, infectious, immunological, and genetic factors appear to be correlated. Clinical manifestations can occur in any organ, however there is predominance in the lungs and in intrathoracic lymph nodes. The cutaneous involvement of the disease occurs in roughly 25% of cases, with cutaneous filling procedures figuring as a potential trigger. The authors of the present article report a case of a patient who had granulomatous lesions on the face following cutaneous filling with hyaluronic acid. In the investigation of cutaneous lesions, the patient presented diagnostic criteria for sarcoidosis, with extensive pulmonary involvement.

Keywords: sarcoidosis; granuloma; hyaluronic acid

Skin cancers in the head and neck region account for 70-75% of malignant cutaneous tumors, of which 80% are basal cell carcinomas. Between 3-6% of malignant cutaneous tumors occur in the auricular pavilion. The authors of the present paper report an alternative technique for reconstructing the ear helix after excision of tumors, without the use of the classic compensation triangle. This method allows that the scar be located in the helical sulcus, resulting in a better aesthetic result, without unaesthetic retractions or scars located transversely to the helix.

Keywords: Dermatologic surgical procedures; Ear, External; Ear neoplasms

Follicular thyroid carcinoma is a well-differentiated tumor, and is considered the second most common subtype of thyroid cancer. Its metastasis usually arises hematogenously — mainly to the lungs and bones — and is considered rare when it occurs cutaneously. The authors report a case of a patient with follicular thyroid carcinoma for 5 years who noticed an erythematous, friable exophytic nodular lesion measuring 1cm on the scalp with 7 months of development, simulating a pyogenic granuloma. Biopsy analysis revealed an adenocarcinoma with glandular differentiation and colloid material in the lumen. The immunohistochemical profile was positive for CK-7 and thyroglobulin, favoring the diagnosis of cutaneous metastasis of primary thyroid neoplasia.

Keywords: Dermatology; Granuloma, Pyogenic; Neoplasms; Neoplasm metastasis

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

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

Sclerosing lipogranuloma is a chronic granulomatous reaction in response to the injection of non-medical substances such as paraffin, silicone, or mineral oil into the skin. This report describes one case of a large defect on the penis following sclerosing lipogranuloma excision surgery that was successfully closed by a double reverse V- Y-plasty reconstruction. The surgery aimed to remove all affected tissue as soon as possible, preventing the persistent granulomatous process that leads to necrosis and severe penile deformity. The double reverse V- Y-plasty is a simple, single-stage procedure useful to reconstruct of a large defect on the penis.

Keywords: Granuloma; Sclerosing solutions; Surgery.

Foreign body granuloma can occur after injection of filling substances into the dermis. We report a case of a 35-year-old woman who performed a self-injectable injection of a commercial serum for exclusively topical use containing hyaluronic acid in the region of the dark circles for aesthetic reasons. After the procedure, she presented a nodule in the lower right eyelid, which she judged to be an accumulation of product. Then she injected betamethasone + hyaluronidase ointment (Postec^®), evolving into a foreign body granuloma.

Keywords: Granuloma; Dermal fillers; Hyaluronic acid