Mohs Reconstruction
Cerclage Closure Technique
HISTORY A 50 y/o patient presents with a 3 year h/o right cheek growing lesion biopsied by outside office on 11/8/21 showing atypical lentiginous melanocytic proliferation. Incisional biopsy of right malar cheek done on 11/18/21 showing severely atypical lentiginous junctional melanocytic hyperplasia with margins involved. Excision and reconstruction with cerclage of right malar cheek severe…
Read More
The Rare Skin Cancers: Sebaceous Carcinomas
HISTORY A 67-year-old man presents w/ a painful right cheek scar s/p Mohs and reconstruction of sebaceous carcinoma done on 4/2019 complicated by salivary fistula. History of drained hematoma and leaking parotid gland s/p surgery. 0.3cc of kenalog 10 mg/cc injected on 9/30/21. Excision of right cheek scar with reconstruction done on 11/29/21. DISCUSSION Sebaceous…
Read More
Sensory Symptoms with Skin Cancers
HISTORY A 68-year-old woman presented with left cheek radiating, shooting pains in the area of biopsy proven basal cell carcinoma. The neuralgia symptoms radiated to the nose, eye, and temple. MRI of the face was non-contributory. Mohs excision was performed by the dermatologist. Additional margin wide local excision was performed at the reconstructive procedure. Patient…
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
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
Recurrent BCC of the External Ear After Radiation
HISTORY A 77-year-old man presents with 5-year history of infiltrative basal cell carcinoma (BCC) of the left ear fossa triangularis and root of helix. The area was originally treated with four weeks of radiation in 2014, complicated by temporary ulceration and healing with adhesion. When the area developed crusting a couple of years later, the…
Read More
Anticoagulant Use in Cutaneous Surgery
HISTORY 87-year-old man with atrial fibrillation presented with squamous cell carcinoma in situ of scalp and forehead. Patient was treated with Mohs and reconstruction on 7-3-18. Incisional hematomas appeared 2.5 weeks post Mohs and treated with I&D. Patient continued warfarin and baby aspirin throughout treatments. DISCUSSION Anticoagulant use in Facial and Dermatologic Surgeries has become…
Read More
Recurrent SCC of Nasal Tip
HISTORY 71-year-old man presents with recurrence of SCC of nose following Mohs excision on 2-9-17. Partial rhinectomy was performed with incomplete Mohs excision leaving residual positive margins due to patient’s comfort. Two additional excisions of involved margins were done under anesthesia achieving clear margins. First stage reconstruction was performed on 4-11-18. DISCUSSION Management of a…
Read More
Upper Chest BCC PNI
HISTORY 53-year-old man presents with a 4-year-history of BCC of upper chest. The tumor measured 12 cm x 6 cm. Wide local excision with 1 cm margins on 11/10/2017 found clear margins and perineural invasion. The nerves up to 0.23 mm were involved by tumor. The final defect was 13.5 cm x 8.3 cm. …
Read More
Cutaneous B-Cell Lymphoma of the Ear
HISTORY 49-year-old woman presents with a shiny pink papule of the left ear helix. Histology found atypical lymphoid infiltrate suspicious for a cutaneous B cell lymphoma. The area was treated with Mohs excision and closure. DISCUSSION Primary cutaneous lymphoma is a low-grade and most-common B-cell lymphoma of the skin. These are primary tumors of…
Read More