Rate of Recurrence of Lentigo Maligna Treated With Off-Label Neoadjuvant Topical Imiquimod, 5%, Cream Prior to Conservatively Staged Excision.

Importance: Staged excision of lentigo maligna (LM) often requires multiple stages and can result in significant cosmetic morbidity. Imiquimod cream has been used off-label as monotherapy in the treatment of LM and may be used in the neoadjuvant setting prior to staged excision as a strategy to reduce the size of the surgical margins required to confirm negative histologic margins.

Objective: To examine the rate of recurrence of LM in patients treated with neoadjuvant topical imiquimod, 5%, cream prior to conservatively staged excisions.

Cutaneous carcinosarcoma: a series of six cases and a review of the literature.

Background: Cutaneous carcinosarcoma is a rare tumor with distinct malignant epithelial and mesenchymal cell populations. The histologic subtypes of epithelial and mesenchymal components in cutaneous carcinosarcoma are variable, as an assortment of carcinomatous and sarcomatous patterns have been described in the literature.

Methods: Clinical information was obtained from patient charts and archival slides were retrieved and reviewed.

Mohs appropriate use criteria: retrospectively applied to nonmelanoma skin cancers at a single academic center.

Background: In September 2012, appropriate use criteria (AUC) for Mohs micrographic surgery (MMS) were released by a collaboration of dermatology organizations including the American College of Mohs Surgery.

Objective: The group sought to determine adherence to the Mohs AUC at the academic institution.

Materials And Methods: The authors performed a retrospective chart review of all nonmelanoma skin cancers (NMSCs) treated within the University of Utah, Department of Dermatology, from January through March of 2012.

A randomized trial of the off-label use of imiquimod, 5%, cream with vs without tazarotene, 0.1%, gel for the treatment of lentigo maligna, followed by conservative staged excisions.

Objective: To determine if the complete response rates of lentigo maligna (LM) to imiquimod, 5%, cream can be improved by the addition of a topical retinoid.

Design: Prospective randomized study of patients treated with imiquimod alone vs imiquimod plus a topical retinoid, followed by conservative staged excisions.

Setting: Mohs surgical clinic in an academic institution.

Use of physician assistants in Mohs micrographic surgery: a survey of fellowship-trained Mohs micrographic surgeons.

Background: An increasing number of dermatologists are using physician assistants (PAs) in their practices. A lack of information regarding the use of PAs in Mohs micrographic surgery (MMS) served as the driving force for this research.

Objectives: To quantify the extent to which Mohs surgeons are using PAs in MMS.

Androgen receptor expression patterns in Becker's nevi: an immunohistochemical study.

Background: Becker's nevus (BN) is a hyperpigmented patch that traditionally presents on the upper torso in adolescent males. Previous studies have reported an association with increased androgen receptors (ARs) in lesional skin in men and women who have associated physical abnormalities.

Objective: This study was conducted to assess the presence of ARs immunohistochemically in female patients with BN but no other physical abnormalities and compare this finding with BN in males and in normal skin.

Nonmelanoma skin cancers of the ear: correlation between subanatomic location and post-Mohs micrographic surgery defect size.

Background: Nonmelanoma skin cancer (NMSC) of the ear can result in large defects with significant morbidity.

Objective: To determine whether subanatomic location of NMSCs, based on ease of visualization of the ear, correlated with post-Mohs micrographic surgery (MMS) defect size.

Methods: A retrospective chart review of 142 post-MMS ear lesions was performed and categorized according to subanatomic location: the helix, antihelix, and tragus (Location 1); retroauricular (Location 2); and conchal bowl, scapha, and triangular fossa (Location 3).

A cosmetic approach to cutaneous defects.

The options available to cosmetic surgeons for the treatment of the aging face are expanding at a rapid pace. Although any one modality may help, often a combination of approaches provides the most dramatic results. Whereas some of these techniques represent refinements of old tools, others represent entirely new modalities (Box 1).