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Mohs Reconstruction

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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…

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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…

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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.  …

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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…

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SCC of Scalp

HISTORY 86-year-old man presents with 3-month history of a mass in the left occipital scalp. 1 year prior, the patient underwent Mohs excision of a large scalp SCC.  FNA biopsy on 1-22-18 found atypical squamous cells. CT PET scan showed cancer limited to the mass itself with no lymph node enhancement. Patient experienced progressively increasing…

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Lower Leg Wound Treatment At Scars Center

Lower Leg Wound Dehiscence

HISTORY 74-year-old man presents with BCC of left lower leg treated with Mohs excision and closure on 2-27-18. Patient presented 5 days post closure with wound dehiscence. Cutimed wound sponge dressing was used for wound management.  Debridement was performed 3-16-18. Plan is for closure with matrix xenograft.       DISCUSSION Lower leg wound dehiscence…

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