Syringoid eccrine carcinoma is a rare adnexal tumor of eccrine origin, and has metastatic potential and high recurrence rate following conventional surgical excision. Mohs micrographic surgery has been commonly used for various malignant skin cancers to minimize the defect after surgery, and to decrease the recurrence rate. We present a case of syringoid eccrine carcinoma successfully treated by Mohs micrographic surgery.
Mohs Surgery* ; Recurrence ; Skin Neoplasms

BACKGROUND

Mohs micrographic surgery (MMS) is the preferred surgical procedure for non melanoma skin cancers (NMSCs), especially in areas where function and cosmesis are critical. It allows precise removal of the tumor while preserving normal skin tissue.

This study aimed to describe the clinicohistopathologic profile of patients who underwent MMS at the Dermatology Center of the St. Luke’s Medical Center, Quezon City, Philippines (SLMC-QC) from March 2003 to March 2023.

This was a descriptive cross-sectional study utilizing a 20-year chart review on all patients who underwent MMS at SLMC-QC from March 2003 to March 2023. Data collected were the following: age, sex, race, clinicopathologic diagnosis, tumor site, pre-operative and post-operative area size, number of MMS stages, type of repair performed, and recurrence, if any.

In 20 years, there were a total of 684 cases done in the Dermatology Center SLMC-QC, and 573 cases with complete data were included. Eighty six percent of patients were over 50 years old. There was a slight male predominance, and most patients were Asians, followed by Caucasians. Basal cell carcinoma was the most common diagnosis followed by squamous cell carcinoma and Bowen’s disease. Majority of the tumors were located on the head and neck. The postoperative defect increased by 2-to-3-fold from the preoperative tumor size in most cases. Most tumors were cleared in 2 stages. The most common type of repair done was flaps, followed by full-thickness skin grafts and primary closures. All primary tumors treated in the center have not recurred within 5 years, bringing the cure rate to 100%.

The clinicohistopathologic profiles of patients in this study are similar to those reported in the literature. No recurrence has been reported in the center and this reflects the effectivity of MMS.

Humans ; Neurothekeoma/surgery* ; Skin Neoplasms/surgery* ; Soft Tissue Neoplasms

BACKGROUND: Mohs micrographic surgery (MMS) is a precise method of treating skin cancer. There have been many studies about the advantages and disadvantages of MMS. However, no study has yet been carried out regarding the length of surgery. OBJECTIVE: The purpose of this study was to report our experience with MMS for the treatment of skin cancers and to analyze the operative time of MMS. METHODS: We analyzed 50 cases of skin cancers treated by MMS at the Dermatosurgery Clinic in Pusan National University Hospital between April 2009 and November 2009. RESULTS: The minimum and maximum operative times of MMS were 88 and 356 minutes, respectively, and the mean operative time was 171.4 minutes. The mean number of stages was 1.7 (range, 1~4). The mean operative time per stage was 93.9, 62.9, 57.2, and 53 minutes for the 1st, 2nd, 3rd, and 4th stages, respectively. The time percentages for a pathologic consult to the Department of Pathology per stage was 42%, 50%, 52%, and 57% for the 1st, 2nd, 3rd, and 4th stages, respectively; therefore, the consultation to the Department of Pathology occupied a high percentage of the operative time. The mean operative time of repair for surgical defects was 44.4 minutes. LIMITATIONS: The results of this study are based on the experience of a single surgical team in a single institution. CONCLUSION: The results of our study reveal that MMS is a time-consuming operation. Further studies are required to shorten the operation time of MMS.
Mohs Surgery ; Operative Time ; Skin Neoplasms

Complete removal is most important in treating the malignant tumor from the auricle, but the cosmetic and reconstructive plan after removal should also be considered because auricular appearance contributes enormously to the facial aesthetics. Mohs micrographic surgery (MMS), which is commonly used in dermatology, is considered as minimal marginal surgery that offers superior cure rates in the treatment of facial skin cancer. Therefore, MMS could provide a minimally invasive way to manage the malignant tumor of the auricle. This article reports that basosquamous cell carcinoma arising in the auricle was treated with wide resection combined with MMS. Conclusively, we could accomplish the surgical purpose of both completely removing the tumor and maintaining the auricular aesthetic shape by additionally introducing MMS in the treatment.
Dermatology ; Esthetics ; Mohs Surgery* ; Skin Neoplasms

BACKGROUND: Repairing large nasal defects in the nose gives us technical challenge. Despite the commonly available surgical techniques, paramedian forehead flap (PFF), an arterial flap, should be considered in repairing some of the large nasal defects. OBJECTIVE: The aim of this study was to evaluate the effectiveness and cosmetic consequences of PFF for the reconstruction of large nasal defects after skin cancer excision. METHODS: Between 2008 and 2011, 8 patients were treated with PFF for reconstruction of large nasal defects after Mohs surgery or wide excision. We reviewed surgical techniques, complications, and final results. Post-operative results were assessed with serial clinical photographs, physicians' objective records and patients' subjective records. RESULTS: The size of surgical defects was ranged from 2.0 to 3.0 cm in their greatest diameter, involving at least 2 cosmetic subunits after tumor excision. Frequent involved sites were nasal tip and nasal dorsum. There were no significant complications, except transient bleeding and oozing. The cosmetic outcomes were considered as good or excellent in most of patients. CONCLUSION: PFF is regarded as the recommended technique for the repair of large nasal defects, involving several cosmetic subunits, providing excellent cosmetic results with few complications.
Cosmetics ; Forehead ; Hemorrhage ; Humans ; Mohs Surgery ; Nose ; Skin ; Skin Neoplasms

BACKGROUND: Repairing large nasal defects in the nose gives us technical challenge. Despite the commonly available surgical techniques, paramedian forehead flap (PFF), an arterial flap, should be considered in repairing some of the large nasal defects. OBJECTIVE: The aim of this study was to evaluate the effectiveness and cosmetic consequences of PFF for the reconstruction of large nasal defects after skin cancer excision. METHODS: Between 2008 and 2011, 8 patients were treated with PFF for reconstruction of large nasal defects after Mohs surgery or wide excision. We reviewed surgical techniques, complications, and final results. Post-operative results were assessed with serial clinical photographs, physicians' objective records and patients' subjective records. RESULTS: The size of surgical defects was ranged from 2.0 to 3.0 cm in their greatest diameter, involving at least 2 cosmetic subunits after tumor excision. Frequent involved sites were nasal tip and nasal dorsum. There were no significant complications, except transient bleeding and oozing. The cosmetic outcomes were considered as good or excellent in most of patients. CONCLUSION: PFF is regarded as the recommended technique for the repair of large nasal defects, involving several cosmetic subunits, providing excellent cosmetic results with few complications.
Cosmetics ; Forehead ; Hemorrhage ; Humans ; Mohs Surgery ; Nose ; Skin ; Skin Neoplasms

Dermatofibrosarcoma/surgery* ; Ear Auricle ; Ear, External ; Humans ; Skin Neoplasms/surgery*

Female ; Humans ; Melanoma/surgery* ; Neoplasms, Multiple Primary/pathology* ; Ovarian Neoplasms/pathology* ; Skin Neoplasms ; Teratoma/surgery*

Skin neoplasms can result in large skin defects after surgical removal. Skin grafting has been used commonly to repair large defects, but it is associated with esthetic and functional problems. Herein, we report three cases with application of the keystone island flap in large skin defects of the trunk and extremities. A 53-year old male with recurred dermatofibrosarcoma protuberans on his thigh was repaired by the keystone island flap after Mohs micrographic surgery, and a 52-year old male with malignant melanoma on his back was successfully reconstructed by the keystone island flap after wide excision. Lastly, a 59-year old male diagnosed with dermatofibrosarcoma protuberans on the inguinal area was closed by the keystone island flap with commendable cosmetic outcome. Due to the ease of performance, excellent cosmetic and functional results, we recommend the keystone island flap for the reconstruction of large skin defects on the trunk and extremities.
Dermatofibrosarcoma ; Extremities ; Humans ; Male ; Melanoma ; Mohs Surgery ; Skin Neoplasms ; Skin Transplantation ; Skin* ; Thigh