Dermoscopy is a proven technique in the in vivo diagnosis of pigmented lesions. New uses in other dermatoses and in the control of clinical and surgical treatments are developing quickly. This article presents some examples of other such applications for dermoscopy.

Keywords: DERMOSCOPY, TICK INFESTATIONS, NEOPLASMS, DERMATOLOGY, VIRUS DISEASES

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

Dermatofibrosarcoma protuberans is an uncommon and relapsing fibrohistiocytic tumor of intermediate malignancy. Its rarest variant is known as atrophic, morphea type or dermatofibrosarcoma non protuberans and its clinical diagnose is difficult. There are not well established dermatoscopic criteria, so the diagnosis is histopathologic. There are advances in immunohistochemical and genetic that help the diagnosis and complete surgical excision. It is reported a case of atrophic dermatofibrosarcoma in a 27 years patient ant it is reviewed the clinical, dermoscopic, histological and genetic aspects.

Keywords: DERMOSCOPY; NEOPLASMS; DERMATOFIBROSARCOMA

Onychomatricoma is a tumor of the nail matrix with well-known clinical features; however, sometimes underdiagnosed. It is often mistaken for onychomycosis due to thickening of the nail plate. dermoscopy of the plate and its free margin allows the visualization of important features for the diagnosis, many times not seen with the naked eye.

Keywords: Dermoscopy; Nail Diseases; Nails/Pathology; Neoplasms

A 74-year-old male patient came to medical consultation presenting a hyperpigmented stain near the lower left eyelid edge, with varying colors, between different shades of brown; the biopsy confirmed the diagnosis of lentigo maligna. Its location on the eyelid edge is rare. There is some divergence in the literature regarding the best method for its treatment. Non-surgical therapeutic options, such as imiquimod, have been suggested, as well as different variants in surgical management and required margins. In the case described, it was chosen to manage with conservative margins, preserving, the functionality of the area.

Keywords: Lentigo; Melanoma; Eyelid Neoplasms; Dermoscopy; Pathology, Surgical; Surgery, Plastic

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

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

Undifferentiated sarcomas are neoplasms of soft tissues derived from the mesoderm. We report a case of undifferentiated pleomorphic sarcoma, its dermoscopy, staging, and therapeutic approach.

Keywords: Dermoscopy; Sarcoma; Soft Tissue Neoplasms

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

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.

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 the most frequent malignant neoplasm in Brazil. Its prognosis is directly related to early diagnosis and institution of adequate treatment. The Skin Cancer National Awareness Campaign (SCNAC) is an essential tool to prevent and detect malignant skin lesions.
OBJECTIVES: To investigate the incidence of skin cancer and the accuracy of dermoscopy in patients assessed at the SCNAC.
METHODS: We conducted a retrospective cohort study using directly the data collected from the population assisted at the SCNAC day in 2016, 2017, and 2018 at Clinical Center of the Universidade de Caxias do Sul (CECLIN-UCS).
RESULTS: Of the 634 patients included, 105 were referred for biopsy with histopathological study of the lesion. Dermoscopy was suggestive of a malignant lesion in 55 cases. Biopsy diagnosed malignant lesions in 43 patients and benign lesions in 32 patients. Thus, the sensitivity and specificity of the test were 86% and 50%, respectively. The accuracy of dermoscopy in identifying malignant lesions over the three years of the campaign was around 70%.
CONCLUSIONS: Dermoscopy in SCNAC has a good level of sensitivity and specificity when correlated with final histopathological results.

Keywords: Dermatology; Dermoscopy; Observational study; Skin neoplasms; Health promotion

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