A patient presents with a fungating giant basal cell carcinoma of the scalp. How was this tumor excised and reconstructed? ePlasty, Open Access Journal of Plastic Surgery

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Mapping is an essential step during Mohs micrographic surgery (MMS) since it allows tumors seen on histology to be tracked during surgery. Histologic findings are typically correlated to the clinical photo or to the hand-drawn map. Despite the increasing use of dermoscopy as an adjuvant tool to help identify basal cell carcinoma, mapping the dermoscopic findings before MMS has not been described to the author ’s knowledge. The author describes the “dermohscopy” mapping to better correlate dermoscopic findings with histology in MMS.

A 78-year-old Caucasian man presented with a 5 mm pink and black papule on his right back. The patient was receiving treatment for squamous cell carcinoma of the tongue and had previously received treatment for basal cell carcinoma. The patient was unaware of the lesion until it was identified by his oncology team, and he denied any associated symptoms. The remainder of the TBSE was unremarkable. Dermoscopic exam revealed central yellow-orange and black clods and small, gray dots which were encircled by a pigmented black-blue annulus.

Perineural invasion has recently been identified as a third route of basal cell carcinoma metastasis, along with lymphatic and hematologic spread. The incidence of perineural invasion in basal cell carcinomas is thought to be

Background: Differentiating between trichoepithelioma and basal cell carcinoma (BCC) is sometimes diagnostically challenging.

Incomplete basal cell carcinoma (BCC) excisions can pose a significant burden to patients and health care providers. These include the need for further treatment prolonged follow-up and recurrence of more aggressive tumor. We aimed to review our incomplete BCC excisions to identify ways to improve our patient outcome and services. Out of 665 non-Mohs Micrographic surgical excisions for BCCs from January to October 2016, in one of the U.K. skin centers 75 (11.2%) were incomplete. Procedures included excision with graft repair (38%), direct closure (35%), flap repair (8%) and double curettage (14%).

We report the case of a 61-year-old Caucasian man with a history of alcoholic cirrhosis and numerous, large, and extensive basal cell carcinomas who was started on vismodegib, and presented 2 weeks later with altered mental status and hypercalcemia, hyperuricemia, and high LDH.

Nevus sebaceus, most often seen on the head and neck, is not uncommon and usually present at birth. This lesion is comprised of abnormalities of the epidermis, hair follicle, sebaceous gland, and other adnexa. Most patients with nevus sebaceus, if they seek medical attention, often wait until the second to forth decade of life. Nevus sebaceus is frequently associated with development of other benign cutaneous neoplasms within the lesion, most commonly syringocystadenoma papilliferum and trichoblastoma-like proliferations (5% each).

Background: Mohs micrographic surgery (MMS) is a precise tissue-sparing surgical technique that increases the success rate of complete excision because all margins were examined microscopically during the procedure. Although MMS is an appropriate treatment for BCC, it is possible in principle only when the tumor margin is visible by the naked eye.

Basal cell carcinoma (BCC), the most common type of skin cancer, accounts for at least 32% of all cancers globally with an incidence that continues to rise. Currently, suspected BCCs are diagnosed initially with partial biopsy, requiring patients to return to clinic for treatment. Treatment depends on the anatomic location, size, and histologic subtype of the tumor, with surgical options including electrodessication and curettage, excision, and Mohs micrographic surgery. In light of the rising incidence of BCC, separate clinic visits for diagnosis and treatment amplify the increasing demand for dermatology services.

Basal cell carcinoma (BCC) is the most common cancer in the United States. The prognosis and treatment protocol for BCC, among other factors, is dependent on the tumor subtype, which can be superficial, nodular/micronodular, or infiltrative. Diagnosis of tumor subtype is made typically on a clinical basis and is supported histologically by either punch or shave tissue biopsy. The agreement between histologic BCC subtype on initial punch biopsy versus after surgical reexcision may be as low as 60.9%.





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