Although basal cell carcinoma can be effectively managed through surgical excision,
the most suitable surgical margins have not yet been fully determined. Furthermore,
micrographic surgery is not readily available in many places around the world. A
review of the literature regarding the surgical treatment of basal cell carcinoma was
conducted in order to develop an algorithm for the surgical treatment of basal cell
carcinoma that could help the choice of surgical technique and safety margins,
considering the major factors that affect cure rates. Through this review, it was
found that surgical margins of 4mm seem to be suitable for small, primary,
well-defined basal cell carcinomas, although some good results can be achieved with
smaller margins and the use of margin control surgical techniques. For treatment of
high-risk and recurrent tumors, margins of 5-6 mm or margin control of the surgical
excision is required. Previous treatment, histological subtype, site and size of the
lesion should be considered in surgical planning because these factors have been
proven to affect cure rates. Thus, considering these factors, the algorithm can be a
useful tool, especially for places where micrographic surgery is not widely
available.
Atualmente, os histiócitos não são mais compreendidos como células únicas, mas como um grupo heterogêneo de células com o mesmo aspecto histológico, mas com características e funções distintas entre si. Várias doenças proliferativas de histiócitos, conhecidas como histiocitoses, são descritas. Tais doenças são raras, e seu estudo costuma ser difícil. Este artigo objetiva simplificar o entendimento desse grupo de doenças, adequando-o a esse novo paradigma da heterogeneidade dos histiócitos.
BackgroundDermatological diseases are among the primary causes of the demand for basic
health care. Studies on the frequency of dermatoses are important for the
proper management of health planning.ObjectivesTo evaluate the nosological and behavioral profiles of dermatological
consultations in Brazil.MethodsThe Brazilian Society of Dermatology invited all of its members to complete
an online form on patients who sought consultations from March 21-26, 2018.
The form contained questions about patient demographics, consultation type
according to the patient's funding, the municipality of the consultation,
diagnosis, treatments and procedures. Diagnostic and therapeutic decisions
were compared between subgroups.ResultsData from 9629 visits were recorded. The most frequent causes for
consultation were acne (8.0%), photoaging (7.7%), nonmelanoma skin cancer
(5.4%), and actinic keratosis (4.7%). The identified diseases had distinct
patterns with regard to gender, skin color, geographic region, type of
funding for the consultation, and age group. Concerning the medical
conducts, photoprotection was indicated in 44% of consultations, surgical
diagnostic procedures were performed in 7.3%, surgical therapeutic
procedures were conducted in 19.2%, and cosmetic procedures were performed
in 7.1%.Study limitationsNonrandomized survey, with a sample period of one week.ConclusionThis research allowed us to identify the epidemiological profiles of the
demands of outpatients for dermatologists in various contexts. The results
also highlight the importance of aesthetic demands in privately funded
consultations and the significance of diseases such as acne, nonmelanoma
skin cancer, leprosy, and psoriasis to public health.
Suction curettage is a dermatologic surgery technique for the treatment of axillary
hyperhidrosis, which is becoming more popular. Objective: The purpose of this study
is to describe the current technique of removal of axillary sweat glands, and
evaluate its efficacy and safety. Conclusion: Suction-curettage of sweat glands is a
minimally invasive surgical technique that is easy to perform, safe, has high rates
of success and relatively few side-effects. It is generally well tolerated by
patients and requires shorter time away from daily activities, when compared with
other surgical modalities.
The authors present part I of a review of multicentric reticulohistiocytosis, a rare systemic proliferative disease of histiocytes of unknown cause. It is clinically characterized by cutaneous and mucosal nodules and by osteoarticular lesions. The disease occurs in outbreaks that progress in severity, with spontaneous regression, but usually leaving incapacitating arthritis and disfiguring facial lesions. The authors discuss the historical, epidemiologic, and clinical aspects of this disease.
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