Tumor de colisão basoescamoso na região de sulco nasogeniano direito em mulher de 50 anos: relato de caso / Basoescamous collision tumor in nasolabial groove region in 50-year-old woman: case report / Tumor de colisión basosescamoso en la región del surco nasogeniani derecho en una mujer de 50 años: reporte de caso

Introdução: Tumor de colisão ou tumor misto é uma neoplasia maligna rara de pele, ainda carente de estudos e casos. A histologia dessa lesão é composta pela sobreposição entre os carcinomas basocelular e epidermoide, ou seja, duas neoplasias com histologias distintas e interface nítida entre ambas. Objetivo: Relatar o caso de uma paciente com carcinoma basoescamoso. Material e Método: Estudo de relato de caso de uma paciente do sexo feminino, 50 anos, com lesão única e progressiva na região de sulco nasogeniano direito. Ao Exame físico: lesão de aspecto papular hiperemiado, com centro ulcerado e crosta central milicérica. Dermatoscopia: teleangiectásias encimadas à área e hiperemiadas. Hipótese diagnóstica sugestiva de Carcinoma Basocelular e/ou Carcinoma Espinocelular. O tratamento realizado foi cirúrgico em 2018, com exame histológico demonstrando a presença de carcinoma de células escamosas contíguo ao carcinoma de células basais. Índices de recidiva local variam de 12% a 45% e os principais fatores prognósticos são o tempo de diagnóstico, margens cirúrgicas, infiltração perineural, órbita ocular, cerebral e cavidade nasal. A paciente, em 2021 evoluiu com uma pápula rósea na mesma região, sulco nasogeniano direito, constituindo uma crosta intermitente, sendo realizada uma ampliação de margem cirúrgica de 0,7cm, e encaminhamento para anatomopatológico detectando-se um pequeno nilho de células basaloides em meio a fibrose dérmica cicatricial. Conclusão: Condição rara, o carcinoma basoescamoso requer diagnóstico diferencial, definido através de critérios histológicos distintos, pois ambas as neoplasias apresentam comportamento clínico semelhante. Tratamento de escolha: ressecção, sendo exérese da lesão com margem livre de segurança ou a micrografia de Mohs as mais indicadas, pode-se associar radioterapia na sua adjuvância, desde que não provoque radiodermite e radionecrose como efeitos adversos.(AU)

Introduction: Collision tumor or mixed tumor is a rare malignant skin neoplasm, still lacking studies and cases. The histology of this lesion is composed by the overlap between basal cell and epidermoid carcinomas, that is, two neoplasms with distinct histologies and a clear interface between both. Objective: To report the case of a patient with basal squamous carcinoma. Material and Method: A case report study of a 50-year-old female patient with a single progressive lesion in the right nasolabial sulcus region. At the physical examination: lesion of hyperemiated papular aspect, with ulcerated center and milicérica central crust. Dermatoscopy: teleangiectasias surmounted to the area and hyperemiadas. Diagnostic hypothesis suggestive of Basal Cell Carcinoma and/or Squamous Cell Carcinoma. The treatment was surgical in 2018, with histological examination demonstrating the presence of squamous cell carcinoma adjacent to basal cell carcinoma. Local recurrence rates range from 12% to 45% and the main prognostic factors are diagnosis time, surgical margins, perineural infiltration, ocular orbit, cerebral and nasal cavity. The patient, in 2021, evolved with a rosy papule in the same region, right nasolabial sulcus, constituting an intermittent crust, being performed a surgical margin enlargement of 0.7cm, and referral for anatomopathological detecting-a small nile of basaloid cells amid cicatricial dermal fibrosis. Conclusion: Rare condition, basal carcinoma requires differential diagnosis, defined by different histological criteria, because both neoplasms present similar clinical behavior. Treatment of choice: resection, since excision of the lesion with a margin of safety or Mohs micrograph are the most indicated, radiotherapy can be associated in its adjuvant, provided it does not cause radiodermitis and radionecrosis as adverse effects.(AU)

Introducción: El tumor de colisión o tumor mixto es una neoplasia maligna rara de la piel, aún carente de estudios y casos. La histología de esta lesión está compuesta por la superposición entre carcinomas de células basales y de células escamosas, es decir, dos neoplasias con histologías distintas y una interfaz clara entre ellas. Objetivo: Reportar el caso de un paciente con carcinoma escamoso basal. Material y Método: Estudio de reporte de caso de una paciente de 50 años de edad con lesión única y progresiva en la región del surco nasolabial derecho. Al examen físico: lesión papular hiperémica con centro ulcerado y costra central milicérica. Dermatoscopia: telangiectasias por encima de la zona e hiperémica. Hipótesis diagnóstica sugestiva de Carcinoma de Células Basocelulares y/o Carcinoma de Células Escamosas. El tratamiento realizado fue quirúrgico en 2018, con examen histológico demostrando la presencia de carcinoma epidermoide contiguo a carcinoma basocelular. Las tasas de recurrencia local oscilan entre el 12% y el 45% y los principales factores pronósticos son el tiempo hasta el diagnóstico, los márgenes quirúrgicos, la infiltración perineural, la órbita ocular, el cerebro y la cavidad nasal. En 2021, el paciente evolucionó con una pápula rosada en la misma región, surco nasolabial derecho, constituyendo una costra intermitente, fibrosis dérmica cicatricial. Conclusión: Una condición rara, el carcinoma basoescamoso requiere un diagnóstico diferencial, definido a través de diferentes criterios histológicos, ya que ambas neoplasias tienen un comportamiento clínico similar. Tratamiento de elección: resección, con escisión de la lesión con margen libre de seguridad o micrografía de Mohs como los más indicados, se puede asociar radioterapia en su coadyuvante, siempre que no provoque radiodermitis y radionecrosis como efectos adversos.(AU)

Long-Term Follow-Up of Longevity and Diffusion Pattern of Hyaluronic Acid in Nasolabial Fold Correction through High-Frequency Ultrasound.

BACKGROUND: Injectable hyaluronic acid fillers have been widely applied in the clinical treatment of facial wrinkles. However, further information and clinical evidence concerning dermal changes and hyaluronic acid filler longevity after injection and diffusion pattern are limited. METHODS: The authors evaluated the longevity and diffusion pattern of two hyaluronic acid fillers generated by different cross-linking technologies used in the treatment of nasolabial folds using high-frequency ultrasound. Forty-one subjects were treated with Restylane 2 and the remaining 41 were treated with Dermalax DEEP. Wrinkle severity rating scale score and high-frequency ultrasound evaluation of nasolabial folds were performed before and after the injection of hyaluronic acid filler. The ultrasound images were acquired and analyzed to determine dermal thickness and the shape and distribution of hyaluronic acid filler. RESULTS: At 2 and 24 weeks from baseline, increased dermal thickness induced by hyaluronic acid filler treatment was not significantly different between groups. At 48 weeks after injection, increased dermal thicknesses of the Restylane 2 group (0.14 ± 0.12 mm) were much lower than those of the Dermalax DEEP group (0.20 ± 0.13 mm). Ultrasound examination revealed that hyaluronic acid materials form well-demarcated and hypoechogenic areas. Restylane 2 tended to form a more diffuse pattern, with multiple smaller bubbles, whereas Dermalax DEEP developed into a more localized configuration, with larger clumps. CONCLUSIONS: This study is the first long-term assessment of nasolabial fold correction that reveals the performance of different hyaluronic acid materials in vivo and validates high-frequency ultrasound as a simple and rapid modality. Hyaluronic acid fillers generated by different cross-linking technologies display differential diffusion patterns in skin tissues. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.

Scandcleft randomised trials of primary surgery for unilateral cleft lip and palate: 8. Assessing naso-labial appearance in 5-year-olds - a preliminary study.

BACKGROUND AND AIM: Facial appearance is one of the most relevant measures of success in cleft lip and palate treatment. The aim was to assess nasolabial appearance at 5 years of age in all children in the project. In this part of the project the local protocol for lip closure continued to be used because the primary lip and nose operations were not part of the randomisation. The great majority of the surgeons used Millard's technique together with McComb's technique for the nose. One center used Tennison-Randalls technique and in one center the centers own technique as well as nose plugs were used. METHODS: Three hundred and fifty-nine children participated in this part of the project. Standardised photos according to a specific protocol developed for the Scandcleft project were taken. Only the nasolabial area was shown, the surrounding facial features were masked. Three components were scored using a 5-point ordinal scale. A new developed Scandcleft Yardstick was used. RESULTS: The reliability of the method was tested using the weighted kappa statistics. Both the interrater and intrarater reliability scores were good to very good. There were statistically significant differences between the three trials. CONCLUSION: The Millard procedure combined with McComb technique had been used in the majority of the cases in all three trials. There were statistically significant differences between the three trials concerning upper lip, nasal form, and cleft side profile. TRIAL REGISTRATION: ISRCTN29932826.

[The nasolabial cyst encountered in the practical work of the otorhinolaryngologists]. / Nosogubnaya kista v praktike otorinolaringologa.

Two clinical observations of nasolabial cyst of uni- and bilateral localizations are reported. The comprehensive characteristic of nasolabial cysts is presented with special reference to the principal diagnostic criteria for this pathology and the potential diagnostic errors.

Functional disorders in patients with lip and nose deformity after cheilorhinoplasty. / Funktsional'nye narusheniya u patsientov s deformatsiei guby i nosa posle odnostoronnei kheilorinoplastiki.

Clinical analysis of the nasolabial complex in patients suffering of the unilateral cleft lip and palate deformity after cheilorhinoplasty is presented in the article. Functional disorders such as nasal breathe impairment and it's relation to the nasolabial muscle dystonia in the dependency of primary cheilorhinoplasty type are analyzed. The plan of surgical treatment as well as the postoperative rehabilitation using the botulotoxin injections is offered.

Asymmetric lip-closing forces in children with repaired unilateral cleft lip and/or palate.

The objectives of this study were to estimate the effects of cleft lip and/or palate (CLP) repair on the multidirectional lip-closing forces (LCF) produced during maximum voluntary pursing-like lip-closing movement in children. Thirty Japanese children were divided into the control group and repaired unilateral CLP (RUCL) group, which was subdivided into the unilateral cleft lip and/or alveolus (UCLA) and the unilateral cleft lip and cleft palate (UCLP) groups. The maximum voluntary LCF were recorded in eight directions. No significant differences in any of the directional LCF (DLCF) or total LCF were observed between RUCL and control groups. Symmetrical DLCF were seen in the oblique directions on both sides of the upper lip in the control group, while the oblique DLCF on the non-cleft side was significantly greater than that on the cleft side in RUCL group. Furthermore, symmetrical vertical DLCF were observed in the upper and lower directions in control and UCLA groups, while the vertical DLCF obtained from the lower direction was significantly greater than that obtained from the upper direction in UCLP group. These results indicate that children with repaired CLP display impaired directional specificity, which may cause secondary deformities. These findings aid our understanding of the pathology of secondary deformities in CLP patients after primary surgery for cleft lip or palate. We propose that quantitative assessments of lip-closing function based on the directional specificity of the multidirectional LCF produced during maximum voluntary pursing-like lip-closing movement are useful for assessing the nature of lip-closing dysfunctions.