Skin cancer discovery during total body skin examinations.

Background: Patients presenting with a site-specific skin complaint may receive a total body skin examination (TBSE) or a more focused examination. A TBSE may be time-consuming but can potentially detect unsuspected or early stage skin cancers. The purpose of this study was to assess the detection of skin cancers associated with dermatologist-initiated TBSE performed immediately after a focused skin examination on the same patients.

Canthal Rotation Flap: Analysis of Flap Mechanics.

Background: Surgical defects of the medial canthus lack reconstructive options that are reproducible, precise, and uncomplicated. The canthal rotation flap is a simple rotation flap that respects the geometry of this anatomic location.

Objective: To describe the authors' experience with reconstructive planning, flap mechanics, and geometric analysis of the medial canthus to achieve the best cosmetic outcome when using the canthal rotation flap.

Two Suturing Techniques for the Prevention and Treatment of Nasal Valve Collapse After Mohs Micrographic Surgery.

Background: Tumor extirpation of nonmelanoma skin cancer (NMSC) adjacent to the alar groove, using Mohs micrographic surgery (MMS), may risk causing internal nasal valve (INV) collapse, resulting in reduced airflow during inspiration. There are many surgical options described in the literature to repair INV collapse as a postoperative corrective procedure, but few exist as an intra-operative preventative procedure.

Objective: The authors present 2 distinct methods to prevent and treat INV collapse during the repair of a perialar surgical defect caused by MMS.

Numerous fibrous papules of the face unassociated with any genodermatosis.

Numerous angiofibromas on the face are commonly associated with tuberous sclerosis or multiple endocrine neoplasia type 1. We present a healthy 66-year-old female with numerous facial angiofibromas, without evidence of tuberous sclerosis, multiple endocrine neoplasia type 1, or any of the less common syndromes associated with many angiofibromas on the face. To our knowledge, there have been no previously reported cases of patients with numerous facial angiofibromas who did not have an associated genodermatosis.

A better technique for taking Mohs sections involving cartilage.

Background: When excising Mohs layers involving skin and cartilage in the conventional manner, it can be difficult to flatten the entire margin onto a single plane because of the inelasticity of the cartilage. This is undesirable, because it prevents a complete examination of the surgical margin.

Objective: We describe a modified technique for excising cartilaginous specimens that allows the entire margin of the specimen to be more easily flattened onto a single plane, so that a complete examination of the surgical margin can be performed.