Nonmelanoma Skin Cancer in Patients Older Than Age 85 Years Presenting for Mohs Surgery: A Prospective, Multicenter Cohort Study.

Importance: It has been suggested that Mohs surgery for skin cancer among individuals with limited life expectancy may be associated with needless risk and discomfort, along with increased health care costs.

Objective: To investigate patient- and tumor-specific indications considered by clinicians for treatment of nonmelanoma skin cancer in older individuals.

Design, Setting, And Participants: This multicenter, prospective cohort study was conducted using data from US private practice and academic centers.

Differences in health care resource utilization and costs for keratinocyte carcinoma among racioethnic groups: A population-based study.

Background: As the United States becomes more diverse, determining differences in health care utilization and costs in the management of skin cancers is fundamental to decision-making in health care resource allocation and improving care for underserved populations.

Objective: To compare health care use and costs among non-Hispanic White, Hispanic White, and non-Hispanic Black patients with keratinocyte carcinoma.

Methods: A nationwide cross-sectional study was performed using Medical Expenditure Panel Survey data from 1996 to 2015.

Mohs Surgery for SEER Registry-Captured Melanoma In Situ and Rare Cutaneous Tumors: Comparing National Utilization Patterns Before and After Implementation of the Affordable Care Act (2010) and Appropriate Use Criteria (2012).

Background: The Affordable Care Act (ACA) and the appropriate use criteria (AUC) for Mohs micrographic surgery (MMS) had the potential to increase utilization rates of MMS for indicated skin cancers, but it is unknown whether this has occurred.

Objective: To determine whether rates of MMS utilization for head and neck melanoma in situ (MIS) and rare cutaneous tumors (RCTs) increased after the implementation of the ACA and AUC publication.

Materials And Methods: Retrospective review using data from the SEER database.

Tips to Avoid Complications Following Mohs Reconstruction.

To avoid complications or bad results following reconstruction of skin cancer defects, there are several factors that can be incorporated into the design and execution of repairs. These techniques not only decrease the need to correct bad results, they improve the final aesthetic and functional outcome. So although one surgeon might focus on standard corrective treatments, another might use elements of flap design and implementation that will decrease the need for such corrective procedures.

Dermal Titanium Dioxide Deposition Associated With Intralesional Triamcinolone Injection.

Cutaneous discoloration secondary to dermal deposition of titanium dioxide (TiO2) particles is recognized but seldom reported in the literature. In this report, the authors describe the case of a 61-year-old gentleman, with a long history of alopecia areata, who presented with numerous, discrete dark blue macules on the scalp. Scanning electron microscopy with energy dispersive x-ray spectroscopy analysis ultimately identified the macules as deposits of TiO2.

Surgical gem: island advancement flaps for lip reconstruction.

Island advancement flaps provide specific advantages for repairing certain defects on the upper lip. We discuss the design and execution of this flap for defects on the alar sill and philtrum.

Bilateral vermilion rotation flap.

Background: Principles of aesthetic reconstruction recommend repair within cosmetic units with tissue of similar color, texture, and thickness. Because of the central facial location and primary functional and aesthetic importance of the lips, successful repair is critical in this location. Numerous procedures to reconstruct the lip have been reported; however, many result in a significant decrease in the oral aperture as well as dysesthesias, limitation of mobility, and significant scarring.

Surgical treatment of obstructive palpebral tumors in d'emblee variant of cutaneous T-cell lymphoma.

Background: Our patient presented with an unusual case of rapidly growing palpebral tumors, which obstructed his vision and caused professional and social impairment.

Objectives: The objective was to report the role of surgical management in a case of the d'emblee variant of cutaneous T-cell lymphoma and to provide a literature review.

Methods: Tumors of the eyelids previously treated with topical and oral retinoids, indomethacin, dapsone, systemic chemotherapy, and high-dose systemic corticosteroids respond finally to conservative excision and second intention healing.