A present a clinical case of a rare variant of dermatofibroma (aneurysmatic type), is presented in a 72-year-old female patient, the lesion was located in the right arm’s flexural fold, resulting from mesenchymal proliferation associated with blood vessels and tissular hemorrhage, with its own well defined histological characteristics. The objectives are to describe the rarity of the lesion and its histopathologic importance, when compared to other benign and malignant tumors in the differential diagnosis, in addition to the terminology currently used.

Keywords: BENIGN FIBROUS HISTIOCYTOMA, MALIGNANT FIBROUS HISTIOCYTOMA, HEMOSIDERIN

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

The solitary dermatofibroma or benign superficial fibrous histiocytoma is a common tumor that arises in the lower limbs of young women. Multiple eruptive dermatofibromas constitute a rare presentation of dermatofibromas (0.3%), often associated with underlying diseases. They are defined by the presence of 15 or more lesions or the appearance of five to eight tumors within less than four months. On PubMed/MEDLINE, to date, there are about 40 published cases of multiple eruptive dermatofibromas related to systemic diseases such as systemic lupus erythematosus, Sjögren's syndrome, hepatitis C, AIDS and the use of imunossupressants. The authors report a case where the emergence of multiple eruptive dermatofibromas preceded the onset of systemic lupus erythematosus by 20 years.

Keywords: HISTIOCYTOMA, BENIGN FIBROUS; LUPUS ERYTHEMATOSUS, SYSTEMIC; IMMUNOSUPPRESSIVE AGENTS.

Rhinophyma is characterized by the hyperplasia of sebaceous glands in the nasal region, associated with a nodular thickening of the skin, enlargement of the pores, and fibrosis in the later stages. It occurs most commonly in male patients bearing rosacea, and may be associated with phymas in the region of the mentum (gnatophyma), ears (otophyma) and forehead (metophyma). The present article describes a case of giant rhinophyma with significant impact on the patient's quality of life, hampering breathing, sleeping, and eating. The lesion was successfully treated with electrosurgery.

Keywords: ELECTROSURGERY; RHINOPHYMA; DERMATOLOGIC SURGICAL PROCEDURES

Introduction: Hyperhidrosis is a common disease characterized by excessive sweating. Several treatment options are described as axillary liposuction and laserlipolysis.
Objective: To compare the effectiveness of two treatment methods for axillary hyperhidrosis – one exclusively surgical (liposuction) and the other employing invasive laser therapy (laserlipolysis) – using a prospective, comparative study with a one-year follow up.
Methods: Liposuction was carried out in the right axilla, while laser lipolysis was performed in the left axilla. The evaluation was conducted using the starch-iodine test, comparative histological analysis and patient self-assessment questionnaires.
Results: Twelve patients took part in the study. The starch-iodine test indicated decreased sweating in all patients within one year after the procedures, while the histological analyses showed absence or reduction of the secreting ducts and acini on both sides and in all cases. After one year of follow-up, the patient's satisfaction index measured by the questionnaires remained positive in all cases, with 75% asserting maximum satisfaction, and 25% reporting difference between the sides (better results were described in the right hand side axilla).
Conclusions: Both techniques showed similar effectiveness after one year of follow-up. Laserlipolysis had a lower frequency of postoperative complications.

Keywords: LASERS; LASER THERAPY; DERMATOLOGY; 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

Hidradenitis suppurativa is a chronic inflammatory, recurrent and debilitating skin disease. Its etiopathogenesis involves follicular occlusion and genetic, environmental and immunological factors. Diagnosis is predominantly clinical, and the therapeutic approach is a major challenge due to its impact on the patient's quality of life. The surgical option is the most indicated in severe cases, nevertheless there is no consensus on the ideal treatment, as outcomes are diverse, and the aesthetic aspect after the procedure is generally unfavorable. This article was aimed at reporting a surgical option with primary wound closure, whose aesthetic result was superior to those derived from traditional techniques.

Keywords: HIDRADENITIS SUPPURATIVA; HIDRADENITIS; DERMATOLOGIC SURGICAL PROCEDURES; DERMATOLOGY; THERAPEUTICS

Introduction: Tuberous sclerosis is a dominant autosomal genodermatosis, classically characterized by facial angiofibromas, fibrotic plaques, periungual fibromas, leaf-shaped hypochromic maculae and fibrous frontal plaques.
Case report: A patient bore this disease, with Koenen tumors in all nail beds of hands and feet, which were resistant to the conventional treatment — simple excision and electrosurgery. Amputation of the nail beds was performed followed by reconstruction with full thickness skin grafts.
Conclusion: The amputation of the nail apparatus and reconstruction with full thickness skin grafts in aggressive, recurrent or high morbidity cases can be an effective therapeutic option.

Keywords: DERMATOLOGY; DERMATOLOGIC SURGICAL PROCEDURES; TUBEROUS SCLEROSIS; SKIN TRANSPLANTS

Introduction: Molluscum contagiosum is a dermatovirosis caused by a poxvirus. In the literature there are descriptions of different therapeutic approaches of this infection.
Objective: To evaluate the efficacy of imiquimod – isolated and associated with curettage – in the treatment of molluscum contagiosum.
Methods: Group A: 20 patients used 5% imiquimod cream 3 times a week for 6 weeks. Group B: 10 patients used a creamy base 3 times a week, for 6 weeks. After the initial 6 weeks, all patients underwent curettage.
Results: Group A: 31% decrease in the number of lesions in the 6th week, with a curettage effectiveness of 97.6%; Group B: 4.8% increase in the number of lesions in the 6th week, with a curettage effectiveness of 81.1%. The mean value for the pain level during curettage was 1.8 for Group A and 3.0 for Group B.
Conclusions: Due to the facts that the rate of cure of contagious molluscum lesions increased and the pain decreased when the curettage procedure was conducted after the use of the immunomodulator, it was possible to conclude that the association of 5% imiquimod cream to the curettage may be a therapeutic possibility.

Keywords: Molluscum Contagiosum; Dermatology; Dermatologic Surgical Procedures

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

Rhinophyma is a disfiguring and progressive disease of the nose with high prevalence. Despite being considered a benign condition, many patients have sought curative treatments due to aesthetic deformity and social stigmatization. There are several surgical techniques described in the treatment of this disease. This report aims to present a case that required an unusual therapeutic approach for the treatment of rhinophyma, given the patient's multiple comorbidities. The procedure was performed with no complications in the intra and postoperative period. The patient maintains an outpatient follow-up with a good long-term aesthetic result.

Keywords: Dermatologic Surgical Procedures; Rhinophyma; Rosacea

Aneurysmal dermatofibroma (DF) is a rare benign tumor originating in the dermis, considered a variant of dermatofibroma. It is more prevalent in women over 30 years of age, in the lower limbs. Its etiology is unknown and histopathological examination confirms the diagnosis. This study reports two cases of aneurysmal DF in young patients, both men, presenting similar lesions: single hyperchromic nodule, with approximately 1.5 cm and progressive growth. This report aims to demonstrate an uncommon variant of dermatofibroma and to highlight the possible differential diagnosis with other tumors through dermoscopic examination.

Keywords: Dermoscopy; Histiocytoma, Benign Fibrous; Dermatology

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

Malignant fibrous histiocytoma (MFH) or undifferentiated pleomorphic sarcoma (UPS) is a sarcoma capable of invading adjacent structures. It is a mesenchymal neoplasia that predominates in men between the sixth and seventh decades of life. It is located mainly in the lower limbs and may affect the head and neck, trunk, and retroperitoneum, presenting a tendency to recurrence and local metastasis. This report aims to present a case of MFH in the ankle of a 49-year-old woman with an adjacent bone invasion, which evolved with transtibial amputation. Clinical, radiological, histopathological, and therapeutic aspects were addressed, highlighting the importance of early diagnosis.

Keywords: Amputation; Malignant fibrous histiocytoma; Sarcoma

Aneurysmal dermatofibroma (ADF) is a rare benign tumor originating in the dermis. It is most common in the lower limbs of women over 30 years. Its etiology is unknown, and histopathological examination confirms the diagnosis. This paper presents a case of ADF with an exuberant presentation in a young female patient with a pedunculated tumor in the right pretibial region, measuring 12 cm in greatest diameter. This report aims to demonstrate an infrequent variant of dermatofibroma with significant growth and emphasize the importance of lesion excision and follow-up because of the high recurrence rate.

Keywords: Histiocytoma, Benign fibrous; Dermatology; Dermoscopy