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

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.

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

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 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

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 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

Basal cell carcinoma (BCC) is the most common skin cancer¹. Among the risk factors for its development are exposure to ionizing and non-ionizing radiation, some chemicals, and previous scars.² However, the most important factor is exposure to ultraviolet radiation, which explains the higher incidence of this neoplasm in photo-exposed areas.¹ BCC in unexposed areas is uncommon. The purpose of this report is to describe a case of recurrent BCC in the vulva, to demonstrate the importance of dermatological examination in unusual areas, and to report the application of Mohs micrographic surgery.

Keywords: Basal cell carcinoma; Vulvar diseases; Vulvar neoplasms

The labia majora become saggy with aging. Although filling with hyaluronic acid provides significant rejuvenation, it can also lead to the formation of true vulvar testicles if poorly indicated, especially in excessively flaccid vulvas, which do not support any further volumization. In these cases of excessive flaccidity, we believe that collagen biostimulators would be the best initial treatment, as their injection would lead to the replacement of dermal collagen and improvement in laxity, without a significant increase in volume. We have been using calcium hydroxyapatite, l-polylactic acid, and PDO threads since 2019, with good results.

Keywords: Vulva; Collagen; Genitalia, Female; Rejuvenation

Despite the therapeutic success described by recent studies, the procedure of labia majora augmentation lacked systematization in order to achieve more assertive and reproducible results. To this end, we developed the vulvar anatomical vector technique, in which we mapped five anatomical structures of the vulva where the injection of hyaluronic acid is capable of promoting coaptation, augmentation, reduction of prolapse, and/or improvement of the skin quality of the labia majora. This technique has allowed us to precisely define the sites to be injected and estimate the adequate volume and type of hyaluronic acid to achieve the intended results.

Keywords: Hyaluronic Acid; Vulva; Dermal Fillers; Rejuvenation; Female Genitalia.