Transposition Flaps in the Reconstruction of Auricular Defects after MOHS Micrographic Surgery.

Background: Closing of ear defects can be a significant surgical challenge, due to the complex three-dimensional cartilaginous structure of this region. Patients and Results: We present a series of 5 retrospective cases of defects on the ear, left after Mohs micrographic surgery for skin cancer, that were repaired with transposition flaps and their Discussions and Conclusion: There are various surgical procedures described for the reconstruction of an ear defect, including local flaps, skin grafts, and even healing by secondary intention. In our opinion, transposition flaps can be a good option when dealing with defects of the tragus, chonca, triangular fossa, superior part of the helix, or even the medial part of the ear. It allows for reconstruction in a single surgical step with decreased morbidity and favorable cosmetic results.

Accuracy of dermoscopic criteria for the differential diagnosis between irritated seborrheic keratosis and squamous cell carcinoma.

BACKGROUND: Even with the addition of dermoscopy, a significant morphologic overlap exists between irritated seborrheic keratosis (ISK) and squamous cell carcinoma (SCC). OBJECTIVE: The aim of this study was to investigate the dermoscopic criteria that could serve as potent predictors for the differential diagnosis between ISK and SCC. METHODS: Dermoscopic images of histopathologically diagnosed ISKs and SCCs were evaluated by 3 independent investigators for the presence of predefined criteria. RESULTS: A total of 104 SCCs and 61 ISKs were included. The main dermoscopic predictors of SCC were dotted vessels (odds ratio [OR], 10.4), branched linear vessels (OR, 5.30), white structureless areas (OR, 6.78), white circles surrounding follicles (OR, 23.45), a diffuse irregular (OR, 2.55) or peripheral (OR, 2.8) vessel arrangement, and a central scale arrangement (OR, 3.35). Dermoscopic predictors of ISK were hairpin vessels (OR, 0.38), a diffuse regular vessel arrangement (OR, 0.39 and OR, 0.36), and white halos surrounding vessels covering more than 10% of the lesion (OR, 0.29 and OR, 0.12). LIMITATIONS: First, the retrospective design of the study; second, the differential diagnosis included in the study was restricted to ISK and SCC. CONCLUSIONS: We confirmed the significant morphologic overlap between ISK and SCC, but we also identified potent predictors for the differential diagnosis between these 2 entities.