Adequacy of surgical margins, re-excision, and evaluation of factors associated with recurrence: a retrospective study of 769 basal cell carcinomas.

BACKGROUND: Achieving adequate surgical margins and preventing recurrence are important in the treatment of basal cell carcinoma (BCC). OBJECTIVES: The objectives of this study were to evaluate the adequacy of surgical margins and the re-excision rates in patients with primary BCC who underwent standard surgical treatment using our proposed algorithm and to define the risk factors in patients with recurrent BCC. METHODS: The medical records of patients who were histopathologically diagnosed with BCC were reviewed. An algorithm created based on previous literature was used to determine the distribution of optimal surgical margins adequacy and re-excision rates. RESULTS: Statistically significant differences were observed between the cases with and without recurrence in age at diagnosis (p=0.004), tumor size (p=0.023), tumor location in the H zone of the face (p=0.005), and aggressive histopathological subtype (p=0.000). When the tumors were evaluated for adequacy of deep and lateral surgical margins and re-excision rates, higher rates of adequate excision (457 cases, 68.0%) and re-excision (43 cases, 33.9%) were noted for tumors in the H or M zone. STUDY LIMITATIONS: Inadequate follow-up of newly diagnosed patients in terms of recurrence and metastasis and the retrospective application of our proposed algorithm are the limitations of the present study. CONCLUSIONS: Our results showed that if BCC was detected at an early age and at an early stage, recurrence was lower. The H and M zones were the regions with the highest rates of optimal surgical outcomes.

Integrated Cadaveric Nail Surgery Course Improves Self-Assessed Knowledge and Competency of Dermatologists.

INTRODUCTION: Dermatologists see many patients with nail disorders requiring surgical interventions. However, nail surgery is often found to be difficult by dermatologists. The aim of this study was to evaluate the effectiveness of an integrated nail surgery course. METHODS: A nail surgery course model, combining anatomy, pathology, and dermatology with theoretical lectures and hands-on training on fresh-frozen cadaver, was designed for dermatologists. Before and after the course, the participants were asked to complete a questionnaire in which they assessed their knowledge and competence levels. RESULTS: Twenty-eight dermatologists completed the questionnaires. The majority of the dermatologists (79.6%) had limited nail surgery experience, previously. The most commonly cited reasons for lack of knowledge or low or moderate theoretical and/or practical level of knowledge of nail surgery were not having received theoretical and practical education during dermatology residency. The median scores of self-assessed knowledge and competency improved significantly after the course (p < 0.001). The majority (82.1%) of the participants were "quite" or "very" well satisfied. CONCLUSION: An integrative nail surgery course model seems beneficial and encouraging for dermatologists. Organizing this type of nail surgery course, especially in medical schools using fresh-frozen cadavers, may significantly improve dermatologists' knowledge and skills.

Evaluating sun protection behaviors and skin self-examination practices among the family members of melanoma patients in Turkey: A cross-sectional survey study.

To evaluate the preventive practices in family members of melanoma patients regarding melanoma in Turkey and compare our results with similar studies by a literature review. A questionnaire-based, cross-sectional study was conducted in 52 participants over the age of 18 years. The questionnaire consisted of the items regarding melanoma risk factors, sun protection behaviors, skin self-examination (SSE), and family communication. Sun exposure (76.9%) and sunburns (69.2%) were relatively well-known melanoma risk factors. The knowledge of risk factors regarding phenotypical features were low (<50%). The participants who were at least high-school graduates had a significantly higher level of knowledge of risk factors. Compliance with sun protection measures (sunscreen, hat, sunglasses, long-sleeve shirt use) was low (19.2%-42.3%) on almost all items with the exception of shade seeking (73.1%). The most common reported reason for not applying sunscreen was not having a habit of sunscreen use. Only one third of the participants (32.7%) performed SSE. The most commonly reported reason for not performing SSE was not knowing the necessity of SSE. The number of participants who stated that they had received information from the melanoma patient about the disease was 19 (36.5%). We documented the knowledge, preventive measures, and family communication deficiency regarding melanoma among family members of melanoma patients. Results of our study may contribute to the development and implementation of educational programs and interventions targeting family members of the melanoma patients.

Prevalence of Congenital Cutaneous Anomalies in 1000 Newborns and a Review of the Literature.

OBJECTIVE: There are limited reports studying on congenital cutaneous anomalies in newborns, particularly in Turkey. Some of congenital cutaneous anomalies serve as an important clue for accompanying syndromes or other medical conditions. This study aimed to determine the prevalence of congenital cutaneous anomalies in newborns and to discuss their clinical significance with a brief review of literature. STUDY DESIGN: A total of 1,000 newborns were examined by a dermatologist in a hospital-based, cross-sectional, prospective study between October 2011 and April 2012. RESULTS: We observed 11 different congenital cutaneous anomalies in 48 newborns of 1,000 (4.8%). The most commonly seen anomalies were sacral dimple, accessory nipple, acrochordon, hypospadias, open spinal dysraphism, and accessory tragus. None of the newborns with cutaneous anomalies had any association. CONCLUSIONS: Although congenital cutaneous anomalies are rare in newborns, clinicians should be aware of them as they may be in association with syndromes and other medical conditions. It is also important to give appropriately provided information to avoid parents concerns.