Dermatoscopy can be used in the pre-operative analysis of melanocytic and non-melanocytic tumors.The effectiveness of this technique can be demonstrated in the selection of the best site for carrying out excisional biopsies, in the delimitation of tumoral margins, in the pre-operative estimation of tumoral thickness of melanomas, and in the screening of recurrences.

Keywords: DERMOSCOPY, SURGERY, DERMATOLOGY, MELANOMA

Seborrheic keratosis are benign epithelial tumors that are usually easily diagnosed through clinical and dermatoscopic examination. They can sometimes resemble malignant lesions, especially melanoma. This article illustrates two such cases, highlighting the detailed dermatoscopic observations that help distinguish these lesions, to help increase the accuracy of diagnoses.

Keywords: KERATOSIS, SEBORRHEIC, MELANOMA, DERMOSCOPY

Cutaneous melanoma’s prognoses depend primarily on the tumor’s thickness; early detection of melanomas is extremely important to increase a patient’s chances of survival. The use of dermatoscopy can be up to 90% accurate. Changes in pigmented lesions may occurduring pregnancy, however the challenge lies in knowing whether such changes are benign or whether they indicate a melanoma. Dermatoscopy is an important diagnostic tool that increases the accuracy of detection and diagnosis of the margins of melanomas in their earliest stages, which consequently improves patients’ prognosis and survival rates.

Keywords: PREGNANCY, MELANOMA, DERMOSCOPY

Introduction: One of the most challenging dermoscopic situations is to distinguish between early melanomas and doubtful benign nevi. At times, suspicious melanocytic lesions have dermoscopic features similar to melanomas, thus leading to excessive excisions of lesions.
Objective: To develop a dermoscopic model that helps to differentiate the doubtful nevus from the early melanoma.
Material and methods: A total of 219 histopathologically confirmed dermoscopic images were analyzed and a comparison between doubtful nevi and early melanomas was then performed.
Results: The final model was based on three dermoscopic features: radial streaming, blue hue and vascular structures. If all three features were absent, it was most likely a nevus; if one dermoscopic feature was present, it could be a nevus or melanoma; if two features were present, there was a greater probability of melanoma diagnosis; if three features were present, it was melanoma.

Keywords: DERMOSCOPY, MELANOMA, NEVUS, PIGMENTED

Four clinical cases of small melanomas detected by dermoscopy associated with clinical data and total body photographs with systematic monitoring are described. In small melanomas, dermatoscopic findings alone are not always sufficient to correctly indicate the excisional biopsies used in anatomical-pathological examinations.

Keywords: DERMOSCOPY, MELANOMA, PHOTOGRAPHY

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

This article describes the case of a 62-year-old patient who developed an erosive nodular mass on the nail apparatus after receiving a trauma during a hunting incident. The lesion was initially diagnosed as an amelanotic melanoma of the nail apparatus, illustrating the fact that this type of lesion is often misdiagnosed – up to 85% of the time if the physician lacks dermatological expertise –and remains untreated for prolonged periods.

Keywords: MELANOMA, MELANOMA, AMELANOTIC, WOUNDS AND INJURIES

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.

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.

A Wood's lamp is a cost effective, safe, easy to use diagnostic tool that is readily available at medical practices. However, its dermatological application has been restricted to the detection of cutaneous infections, the evaluation and classification of pigmentation disorders (such as melasma and vitiligo), and the analysis of disturbances in the metabolism of porphyrins. In the present report the authors demonstrate the use of a Wood's lamp as an alternative to confocal optical microscopy, in the delimitation of the surgical margins of a hypomelanotic lentigo maligna melanoma, whose lack of melanin pigmentation and tumor location in a photodamaged area had hampered a patient's surgical planning.

Keywords: LIGHT; MELANOMA; MELANOMA, AMELANOTIC; MICROSCOPY, CONFOCAL;

The nevus spilus (NS), also known as speckled lentiginous nevus or nevus on nevus, is represented by a brownish macule on which small macules of darker shades appear. It is more common on the trunk and lower limbs. The general population's prevalence is 0.2% to 2.3%, and they have a benign character. The exact risk for malignant transformation is still unknown; thus, it demands a routine clinical-dermoscopic follow-up. We present a case of malignant melanoma on acquired nevus spilus, in which early an excision was performed, with no recurrence, highlighting the importance of follow-up of these patients.

Keywords: Melanoma; Nevi and melanomas; Nevus

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

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