David Serra

Incidence and factors associated with recurrence after incomplete excision of basal cell carcinomas: a study of 90 cases.

Background  Management of incompletely excised basal cell carcinomas (BCC) remains controversial.

Reflectance confocal microscopy of blue nevus.

ejd.2012.1746 Auteur(s) : Susana Puig1,2 susipuig@gmail.com, Thais Bello Di Giacomo1, David Serra1, Florencia Cabrini1, Llucia Alos3, Josep Palou3, Josep Malvehy1,2 1 Melanoma Unit, Department of Dermatology 2 CIBER de Enfermedades Raras, Barcelona, Spain 3 Melanoma Unit, Department of Pathology, Hospital Clinic, IDIBAPS, C/Villarroel n°170, 08036 Barcelona, Spain Reflectance confocal microscopy (RCM) is an emerging technique for the assessment of pigmented lesions. It allows in vivo imaging of [...]

Linear psoriasis - a case report.

A 56-year-old woman presented with a 3-month history of erythematous plaques covered by scales and limited to the right side of her body. The plaques were arranged along Blaschko’s lines with a marked mid-line cutoff. The histopathologic analysis of a skin biopsy in conjunction with the anamnesis allowed the diagnosis of linear psoriasis. Our patient showed a good clinical response to antipsoriatic treatment.

Prediction of Sentinel Node Status and Clinical Outcome in a Melanoma Centre

Background. Sentinel lymph node biopsy (SLNB) is a standard procedure for patients with localized cutaneous melanoma. The National Comprehensive Cancer Network (NCCN) Melanoma Panel has reinforced the status of the sentinel lymph node (SLN) as an important prognostic factor for melanoma survival. We sought to identify predictive factors associated with a positive SLNB and overall survival in our population. Methods. We performed a retrospective chart review of 221 patients who have done a successful SLNB for melanoma between 2004 and 2010 at our department. Univariate and multivariate analyses were done. Results. The SLNB was positive in 48 patients (21.7%). Univariate analysis showed that male gender, increasing Breslow thickness, tumor type, and absence of tumor-infiltrating lymphocytes were significantly associated with a positive SLNB. Multivariate analysis confirmed that Breslow thickness and the absence of tumor-infiltrating lymphocytes are independently predictive of SLN metastasis. The 5-year survival rates were 53.1% for SLN positive patients and 88.2% for SLN negative patients. Breslow thickness and the SLN status independently predict overall survival. Conclusions. The risk factors for a positive SLNB are consistent with those found in the previous literature. In addition, the SLN status is a major determinant of survival, which highlights its importance in melanoma management.

Melanoma: when dermoscopy is a pitfall

References 1 Fischer J. Autosomal recessive congenital ichthyosis. J Invest Dermatol 2009; 129: 1319–1321. 2 Akiyama M, Takizawa Y, Kokaji T, et al. Novel mutations of TGM1 in a child with congenital ichthyosiform erythroderma. Br J Dermatol 2001; 144: 401–407. 3 Herman ML, Farasat S, Steinbach PJ, et al. Transglutaminase-1 gene mutations in autosomal recessive congenital ichthyosis: summary of mutations (including 23 novel) and modeling of TGase-1. Hum Mutat 2009; 30: 537–547.

Melolabial fold interpolated flap for reconstruction of complex nasal defects

Complex surgical nasal defects are often technically difficult. We report the case of a 71-year old male diagnosed with a malignant melanoma (animal type; Breslow 1.5; Clark IV) on the right nasal ala. Radial excision with margins of approximately 1.5 cm was performed, creating a complex full-thickness surgical defect involving the free wall and margin of the right nasal ala, the right soft triangle, nasal lobe and columella, which was reconstructed using a melolabial interpolated flap, with highly satisfactory final esthetic result. Interpolated flaps are viable surgical options for the reconstruction of surgical defects for which local flaps and skin grafts are not suitable.

Trichilemmal cyst nevus of the scalp.

We report the observation of a 24-year-old woman presenting a plaque-like lesion of the occipital scalp with hair rarefaction. This lesion was congenital and consisted of numerous, agminated, very small, trichilemmal cysts. It remained stable since birth, slowly growing in proportion with the patient during childhood. We discuss the nosological status of this intriguing lesion and its relationship with the recently described trichilemmal cyst nevus.

Postauricular pull-through transpositional flap: An option for one-stage reconstruction of anterior auricle defects

Abstract The reconstruction of anterior-superior defects of the auricle is usually a challenging task. We describe three patients with non-melanoma skin cancer localized in the upper portion of the antihelix. Tumour sizes ranged from 0.6 cm to 1.3 cm. All patients underwent a postauricular pull-through transpositional flap to repair the primary defect. The donor sites were closed using a T-plasty. The final results were aesthetically good. The main advantages as well as disadvantages of this one-stage reconstruction of anterior auricle defects are discussed.