Call Us Today:
949.200.1600

Patient Case Studies

Dermatofibroma to Dermal Sarcoma: The Spectrum of Dermal Spindle Cell Tumors

HISTORY A 54-year-old woman with no history of skin cancers presented with 4 month h/o growing left cheek nodule. After a shave biopsy that suggested a dermatofibroma, the tumor progressed to ulceration . A 74-year-old man presented with a 2 month h/o bleeding, ulcerated nodule of left antitragus. He has a history of several skin…

Read More

Evaluation of Longitudinal Melanonychia

HISTORY An 84-year-old woman with a history of melanoma of the left upper back presents with an 11 month h/o left great toe discoloration. Biopsy of left great toe was performed on 08/05/2019. Previous h/o discoloration of the right fifth toe was biopsied and was negative for malignancy. DISCUSSION What is the cause of melanonychia…

Read More

Intralesional 5-fluorouracil for Cutaneous BCC and SCC

HISTORY  An 86-year-old man on hemodialysis with multiple medical problems and on warfarin presented with two carcinomas of the nasal tip: BCC of the left nasal tip and SCC of the right nasal tip. The ulceration of the right SCC exposed the alar cartilage. Patient completed six (6) 5-fluorouracil injections over a 5-week period. Complete…

Read More

Nasal Open Wound Complication

HISTORY A 73-year-old man with BCC of the nasal tip presented 1 week following Mohs excision. His reconstruction was delayed for an additional week for a cardiac work up. Nasal reconstruction was performed with a superior extended nasal myocutaneous flap (SENMI flap) and nasal septal cartilage grafts. The patient developed nasal tip incisional discharge 1…

Read More

Sentinel Lymph Node Biopsy for Cutaneous SCC

HISTORY A 58-year-old kidney transplant recipient presented with a 6-month history of squamous cell carcinoma of the left scalp. This large lesion was adjacent to the scar of a previous carcinoma excision in 2014. Patient is on sirolimus for his kidney transplant performed in 1984. He has had multiple BCCs and SCCs of scalp, back,…

Read More

Near-Infrared Laser Lymphangiography Sentinel Lymph Node Biopsy for Melanoma

HISTORY A 61-year-old male presents for 1.5 cm malignant melanoma of left posterior shoulder invading to at least 1.2 mm (Clark’s Level IV) on a shave biopsy. Left shoulder melanoma was excised, and a left axillary sentinel lymph node was biopsied. Small focus of residual melanoma was found in the primary site, but none in…

Read More

Atypical Nevus – a Melanoma Precursor? Not Exactly

HISTORY A 27-year-old woman presented with many-year history of left cheek nevus. The lesion grew in size and changed in color. Shave biopsy showed a nevus with moderate atypical melanocytic hyperplasia. Residual pigmentation of the nevus and involved histologic margins remained after the biopsy. DISCUSSION Are all atypical melanocytic lesions pre-melanomas? Should dysplastic lesions be…

Read More

Pediatric Office Procedures with PRO-NOX™ Nitrous Oxide

HISTORY An 8-year-old girl presents with a 1 year history of dark mole of the right lower eyelid. Initially presenting as a small freckle, it grew and darkened in color. Right lower eyelid excisional biopsy was performed utilizing PRO-NOX™ nitrous oxide system. Biopsy showed intradermal nevus, combined type (primarily a common blue nevus and a…

Read More

Nasal Skin Graft Revision with Flaps

HISTORY The patient presented for scar revision 8 months after Mohs excision of BCC of the nose and closure with an ear skin graft, performed elsewhere. Patient presents for correction of the atrophic erythematous skin graft scar. The patient was treated with two signature flaps of the SCARS Center developed for nasal reconstruction. DISCUSSION The…

Read More

Leiomyosarcoma of Scalp

HISTORY An 84-year-old man presented with a 7-month history of 2.5 cm ulcerated nodule of the scalp. Biopsy showed a poorly defined neoplasm consistent with a leiomyosarcoma. Wide local resection with 1 cm margins cleared the tumor. The 5 cm scalp defect was reconstructed with multiple large scalp rotation flaps. DISCUSSION Spindle cell neoplasms of…

Read More