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Reconstructive Techniques

Mitoses in a Dysplastic Nevus

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HISTORY 61-year-old man presents with 6-month history of forehead lesion. Biopsy on October 2017 showed atypical nevomelanocytic neoplasm with several mitoses (3/mm2).  An excision with 5 mm margins was performed in November 2017 with negative findings. DISCUSSION This melanocytic tumor of uncertain malignant potential can also be called a MELTUMP. These lesions present a treatment…

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Cerclage Closures

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DISCUSSION Cerclage closure is a relatively straightforward approach to wound repair in certain locations. Body regions with no appreciable skin creases or relaxed skin tension lines are good candidates for this technique. Regions with inherently high tension of closure is all directions, such central chest and convex shoulder, heal better with a cerclage scar versus…

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Reconstructive Cases – Bilevel Grafts

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DISCUSSION Nasal ala skin defects can be reconstructed with skin grafts generally with excellent results. However, deeper defects of the nasal ala repaired with a skin graft may result in a depressed deformity. Contraction of skin graft healing may also cause retraction of the nasal ala, especially with deeper defects. Adding a cartilage graft  to…

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BCC Left Upper Lip

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HISTORY 87-year-old man presents with 1 year history of lesion on left upper lip.  Biopsy taken 11-16-2017 and pathology showed basal cell carcinoma. Mohs excision and reconstruction were performed on 1-19-18. Mohs slide histology was presented for review. A question of appearance of perineural invasion was discussed.       DISCUSSION   The Mohs slides…

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Recurrent SCC of Nasal Tip

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HISTORY 71-year-old man presents with recurrence of SCC of left nose. Mohs excision of left nasal tip SCC was performed on 2-9-17. Left nasal fullness under flap, initially thought to be a scar, progressed until drainage appeared. Pathology of draining debris under flap showed invasive squamous cell carcinoma.  Intranasal mapping biopsies were performed on 2-12-18.…

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Scalp Reconstruction 3

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Patient diagnosed with malignant melanoma of midline forehead. Mohs excision performed by primary dermatologist. Forehead/scalp reconstruction performed by Dr. Simon Madorsky at SCARS Center.  

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Scalp Reconstruction 2

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Patient diagnosed with nodular and micronodular Basal Cell Carcinoma of left forehead. Mohs surgery performed by Dr. Gregory Bartlow. Forehead/scalp reconstruction performed by Dr. Simon Madorsky at SCARS Center.   

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Nose Reconstruction 7

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Patient diagnosed with Basal cell carcinoma of left nose and cheek. Mohs surgery performed by primary dermatologist. Nose reconstruction performed by Dr. Simon Madorksy at SCARS Center.                

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