Patient Case Studies
Superior Extended Nasal Myocutaneous Island Flap: An Alternative to Forehead Flap Reconstruction of the Nose
SCARS Center has published a scientific article in Facial Plastic Surgery and Aesthetic Medicine, formerly known as JAMA Facial Plastic Surgery, the official journal of the American Academy of Facial Plastic and Reconstructive Surgery. This article introduces an innovative approach for reconstruction of medium to large nasal defects. Medium and large nasal defects are mostly…
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A Case of Mistaken Identity: Porocarcinoma of the Scalp Initially Diagnosed as Basal Cell Carcinoma
History A 72-year-old man presented with a 2 year history of right anterior scalp lesion. The lesion was previously treated by an outside physician with cryosurgery multiple times over the course of 1 year. After a lack of resolution, the lesion was biopsied resulting in a diagnosis of basal cell carcinoma. No further treatment was…
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Multiple Cutaneous Carcinomas in Organ Transplant Recipients
HISTORY A 73-year-old kidney transplant recipient presented with multiple carcinomas including SCC, SCC in situ, and BCC of the face and scalp. DISCUSSION Organ transplant recipients can suffer from multiple cutaneous carcinomas. Some lesions can have a high risk of metastases, but most occur in multitudes in areas of extensive sun exposure. At SCARS Center,…
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Desmoplastic / Spindle Cell Melanoma of the Scalp
A 67-year-old man with CLL presents with 3 month h/o 3 cm dense dermal growing scalp mass. Incisional biopsy showed spindle cell melanoma. The tumor was resected with a 2 cm margin. Final pathology showed malignant melanoma—spindle cell / desmoplastic type. Additional 1.2 cm margin was resected for wide clearance creating a 10 x 9…
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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…
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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…
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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…
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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…
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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,…
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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…
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