Risk of a Second Skin Cancer in a Cohort of Patients With Nonmelanoma Skin Cancer -Basal Cell Carcinoma or Squamous Cell Carcinoma-Treated With Mohs Micrographic Surgery: A National Prospective Cohort Study. / Riesgo de aparición de segundas neoplasias cutáneas en una cohorte de pacientes diagnosticados de carcinoma queratinocítico (carcinoma basocelular y carcinoma epidermoide) tratados con cirugía de Mohs. Estudio de cohortes prospectivo nacional.

OBJECTIVE: Patients with nonmelanoma skin cancer (NMSC)-ie, basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)-have an increased risk of developing a second skin cancer. The aim of this study was to describe the frequency, incidence per 1000 person-years, and predictors of a second skin cancer in a cohort of patients with NMSC treated with Mohs micrographic surgery (MMS). MATERIAL AND METHODS: Prospective study of a national cohort of patients with NMSC who underwent MMS at 22 Spanish hospitals between July 2013 and February 2020; case data were recorded in the REGESMOHS registry. The study variables included demographic characteristics, frequency and incidence per 1000 person-years of second skin cancers diagnosed during the study period, and risk factors identified using mixed-effects logistic regression. RESULTS: We analyzed data for 4768 patients who underwent MMS; 4397 (92%) had BCC and 371 (8%) had SCC. Mean follow-up was 2.4 years. Overall, 1201 patients (25%) developed a second skin cancer during follow-up; 1013 of the tumors were BCCs (21%), 154 were SCCs (3%), and 20 were melanomas (0.4%). The incidence was 107 per 1000 person-years (95% CI, 101-113) for any cancer, 90 per 1000 person-years (95% CI, 85-96) for BCC, 14 (95% CI, 12-16) per 1000 person-years for SCC, and 2 (95% CI, 1-3) per 1000 person-years for melanoma. More men than women developed a subsequent skin cancer (738 [61%] vs 463 [39%]). The main risk factors were a history of multiple tumors before diagnosis (relative risk [RR], 4.6; 95% CI, 2.9-7.1), immunosuppression (RR, 2.1; 95% CI, 1.4-3.1), and male sex (RR, 1.6; 95% CI, 1.4-1.9). CONCLUSION: Patients have an increased risk of developing a second tumor after MMS treatment of NMSC. Risk factors are a history of multiple tumors at diagnosis, immunosuppression, and male sex.

Reconstrucción de defecto quirúrgico en el cuero cabelludo mediante matriz dérmica bicapa e injerto laminar / Scalp Defect Reconstruction Using a Bilayer Dermal Wound Matrix and a Split-Thickness Skin Graft

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Colgajos cutáneos para la resolución de múltiples tumores próximos adyacentes / Skin Flaps for the Repair of Multiple Adjacent Tumors

En la práctica diaria, es frecuente que el cirujano dermatológico deba extirpar varias lesiones tumorales próximas entre sí en la región facial. Para ello, es importante planificar una técnica reconstructiva adecuada que permita, si es posible, abordar las lesiones en un solo acto quirúrgico, proporcionando buenos resultados funcionales y estéticos. A continuación se presentan 5 casos de pacientes en los que se ha empleado un único colgajo para realizar el cierre de varios defectos próximos

In daily clinical practice, the dermatologic surgeon frequently has to excise closely adjacent tumors in the facial region. In such cases, planning of an appropriate reconstruction technique is essential. The aim is to treat all of the lesions in a single surgical intervention, if possible, and to achieve a good functional and cosmetic outcome. We present 5 patients in whom a single flap was used to repair multiple adjacent defects

Skin Flaps for the Repair of Multiple Adjacent Tumors.

In daily clinical practice, the dermatologic surgeon frequently has to excise closely adjacent tumors in the facial region. In such cases, planning of an appropriate reconstruction technique is essential. The aim is to treat all of the lesions in a single surgical intervention, if possible, and to achieve a good functional and cosmetic outcome. We present 5 patients in whom a single flap was used to repair multiple adjacent defects.

Comentario a: “Hidrosadenitis supurativa: nuevas oportunidades para una enfermedad dermatológica huérfana” / Comment on “Hidradenitis Suppurativa: New Opportunities for an Orphan Skin Disease”

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Colgajo condro-cutáneo en isla para la reconstrucción e un defecto de antehélix / Chondrocutaneous Island Flap for Reconstruction of an Antihelix Defect

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Combinación de colgajo cutáneo de rotación con colgajo mio-mucoso de lengua para la reconstrucción de defecto del labio superior / No disponible

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Matricectomía ungueal parcial con láser de CO 2 / Partial Nail Matricectomy with Carbon Dioxide Laser

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Colgajo de pedículo subcutáneo en V-Y: su utilidad en la reconstrucción quirúrgica del pabellón auricular / Subcutaneous Pedicled V-Y Advancement Flap for Surgical Reconstruction of the Auricle of the Ear

El colgajo de pedículo subcutáneo en V-Y es útil en la cobertura de defectos de pequeño-mediano tamaño en áreas donde es fácil obtener un buen pedículo subcutáneo (labio superior, región malar, ciliar, punta y alas nasales). La práctica ausencia de tejido subcutáneo en la cara anterior del pabellón auricular condiciona su uso en esta localización. Presentamos 4 casos en los que utilizamos este colgajo para la reparación de defectos quirúrgicos ubicados en hélix, fosa escafoidea y antitrago, con un buen resultado funcional y estético

The subcutaneous pedicled V-Y advancement flap is useful for the repair of small and medium-sized defects in areas where it is easy to obtain a good subcutaneous pedicle (upper lip, cheek, eyebrow, and nasal tip and ala). The almost complete absence of subcutaneous tissue on the anterior aspect of the auricle of the ear can limit the use of this approach in this region. We present 4 patients in whom subcutaneous pedicled V-Y advancement flaps were used to repair surgical defects of the helix, scaphoid fossa, and antitragus, achieving a good functional and aesthetic result in all cases

Cirugía reconstructiva de la región cigomática-medial de la mejilla: Presentación de 5 casos / Reconstructive Surgery of the Medial Zygomatic Region of the Cheek: Presentation of 5 Cases

La mejilla es la subunidad anatómica mayor de la cara. Es una estructura bilateral, por lo que es necesario respetar la simetría. Por otra parte contacta periféricamente con importantes orificios naturales cuya localización debemos respetar en la reconstrucción quirúrgica. Esto es particularmente importante en la subunidad cigomático-medial, cuya delicada unión con el párpado inferior hace que tengamos que ser cuidadosos para evitar un ectropión. Presentamos 5 opciones reconstructivas de defectos quirúrgicos secundarios a la extirpación de otros tantos tumores en esta localización

The cheek is the largest anatomical subunit of the face. It is a bilateral structure and symmetry must therefore be preserved. Peripherally it is related to important natural orifices whose location must also be maintained during surgical reconstructions. This is particularly important in the medial zygomatic subunit, whose delicate junction with the lower eyelid means that care must be taken to avoid ectropion. We present 5 options for the reconstruction of surgical defects secondary to the excision of tumors in this region

Reconstructive surgery of the medial zygomatic region of the cheek: presentation of 5 cases.

The cheek is the largest anatomical subunit of the face. It is a bilateral structure and symmetry must therefore be preserved. Peripherally it is related to important natural orifices whose location must also be maintained during surgical reconstructions. This is particularly important in the medial zygomatic subunit, whose delicate junction with the lower eyelid means that care must be taken to avoid ectropion. We present 5 options for the reconstruction of surgical defects secondary to the excision of tumors in this region.

Injerto condro-pericóndrico auricular en la reconstrucción del párpado inferior / Auricular Chondro-Perichondrial Graft in the Reconstruction of the Lower Eyelid

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