BACKGROUND: Skin cancer is the most common malignancy and can be treated in various ways. One treatment modality is Mohs micrographic surgery. Due to the increasing incidence of skin cancer in the last decades, there is a need for improvement of the Mohs technique to optimize its effectiveness. OBJECTIVE: The aim of this study was to evaluate the use of dermoscopy to guide demarcation of Mohs micrographic surgery margins and ascertain whether this method can reduce operative time and, therefore, reduce surgical morbidity and cost. METHODS AND MATERIALS: The sample comprised 44 patients who underwent Mohs micrographic surgery, allocated into two groups: the control group and the intervention group. In the latter, surgical margins were guided by dermoscopy. RESULTS: There were no statistically significant differences between the two groups by chi-square analysis (p = 0.399). CONCLUSION: Although outcomes were similar in the two groups, demonstrating that dermoscopy does not help in the demarcation of surgical margins for Mohs micrographic surgery, the study provides a practical proposal for improvement of the Mohs technique.

O caso demonstra apresentação atípica de verrugas vulgares no dorso das mãos de paciente do sexo masculino de 53 anos e com história prévia de tratamento para linfoma de Hodgkin. As pápulas espiculadas, confluentes, de superfície rugosa, com centro ceratótico e ligeiramente descamativas são comparáveis a cristais de rocha.

This case demonstrates an unusual presentation of verruca vulgaris on the dorsum of the hands in a 53 year-old man with previous history of treated Hodgkin lymphoma. The spiculate, confluent and rough-surfaced papules, with slight desquamation and keratotic core are comparable to rock crystals.

Alopecia frontal fibrosante é forma progressiva de alopecia cicatricial. Os casos iniciais foram relatados a partir 1994, na Austrália, em pacientes do sexo feminino pós-menopausa. Desde então inúmeros casos foram descritos na literatura sugerindo que ela é mais prevalente do que inicialmente se supunha. Seu curso progressivo se assemelha ao da alopecia androgenética; histologicamente, entretanto, o infiltrado liquenóide é evidente. O artigo relata seis casos brasileiros e discute a alopecia frontal fibrosante dentro do grupo das alopecias cicatriciais, como variante do líquen plano pilar.

Frontal fibrosing alopecia is a progressive cicatricial alopecia. The first cases were described in Australia in postmenopausal women, in 1994. Since then, numerous cases were reported, suggesting that frontal fibrosing alopecia is more prevalent than initially thought. Its progressive course in postmenopausal women, clinically resembles androgenetic alopecia; however, histologically, lichenoid infiltrate is evident. This article report six brazilian cases of frontal fibrosing alopecia and discusses them in the context of cicatricial alopecias, as a variant of lichen planopilaris.

Piloleiomioma é tumor benigno de músculo liso que tem origem no músculo eretor do pêlo. Pode ocorrer isoladamente ou em grande número. Apresenta-se doloroso, sensível ao frio, toque, pressão e emoção. Relata-se caso de um homem com nódulos intradérmicos compostos por fibras de músculo liso. A imuno-histoquímica mostra-se positiva para desmina e actina, confirmando o diagnóstico.

Piloleiomyoma is a benign smooth muscle tumor which arises from the erector pilorum muscles. The lesions can be solitary or multiple. They are painful, tender to cold, touch and pressure and sensitive to emotions. The authors report the case of a man with intradermal nodules composed of smooth muscle fibers. Immunohistochemical staining was positive for desmin and actin, thus confirming the diagnosis.

Pseudoxantoma elástico perfurante periumbilical é distúrbio adquirido do tecido elástico, que acomete mulheres multíparas. Apresenta-se um caso dessa condição em mulher de 74 anos (G10, P10) mostrando placa amarelada de aspecto reticular com áreas constituídas por pápulas eritêmato-ceratósicas. A histologia demonstra derme reticular com fibras conjuntivas basofílicas e irregulares, além de área de hiperplasia epidérmica, com eliminação de fibras elásticas através de canal repleto de ceratina.

Periumbilical perforating pseudoxanthoma elasticum is an acquired disorder of the elastic tissue found most frequently in multiparous women. A case of this condition is reported for a 74 year-old woman (G10, P10) showing yellow, reticulated plaque with erithematous and keratotic papules. Histology shows reticular dermis with irregular basophilic conjunctive fibers, as well as epidermal hyperplasia and elastic fibers elimination through keratotic channels.

Condição adquirida, sistêmica, caracterizada por tromboses recorrentes no sistema arterial, venoso ou ambos, a síndrome antifosfolípide pode ser primária ou secundária, esta última mais associada ao lúpus eritematoso sistêmico e menos freqüentemente a infecções, fármacos e outras doenças. São marcadores sorológicos da síndrome antifosfolípide os anticorpos antifosfolípides anticoagulante lúpico e anticardiolipina. O critério diagnóstico primário inclui trombose arterial ou venosa e morte fetal recorrente. Cerca de 41% dos pacientes apresentam lesões cutâneas como primeiro sinal da síndrome, que também pode provocar livedo reticular, ulcerações cutâneas, vasculite livedóide, entre outras manifestações. Seu controle consiste principalmente no tratamento e profilaxia da trombose com anticoagulantes e antiagregantes plaquetários.

Antiphospholipid syndrome is an acquired multisystem disorder characterized by recurrent thromboses in the arterial system, venous system, or both. Antiphospholipid syndrome is classified into 2 groups: primary and secondary. Secondary antiphospholipid syndrome is often associated with systemic lupus erythematosus and less frequently with infections, drugs and other diseases. Serologic markers are antiphospholipid antibodies, lupus anticoagulant and anticardiolipin. The primary diagnostic criteria include arterial thrombosis or venous thrombosis and recurrent fetal loss. About 41% of patients with lupus anticoagulant have skin lesions as the first sign of antiphospholipid syndrome. Cutaneous manifestations include livedo reticularis, cutaneous ulceration and livedo vasculitis. The mainstays of prophylaxis and treatment of thrombosis are anticoagulant and antiplatelet agents.