Pigmented tumors have similar clinical features that overlap and hamper diagnosis. Dermoscopy increases the diagnostic accuracy of doubtful melanocytic lesions and has been used as a noninvasive tool in the detection of pigmented lesions (PLs) like melanoma, basal cell carcinoma, and pigmented Bowen's disease (pBD). Our objective was to show the dermoscopic features of 2 cases of pBD and compare with the findings reported in the literature. Two dermoscopic images of biopsy proven pBD were retrospectively analyzed for dermoscopic patterns. Both cases showed brown regular globules, structureless brown and blue pigmentation, glomerular vessels, hypopigmented regression-like areas, and keratosis. These findings were similar to the cases reported previously. The dermoscopic diagnosis of pBD is based on the absence of criteria for a melanocytic lesion in the presence of glomerular vessels, regular brown globules and keratosis. Although pBD is rare, it should be included in the differential diagnosis of PLs, especially melanoma.

Foreign modelling agent reactions (FMAR) are the result of the injection of unapproved high-viscosity fluids with the purpose of cosmetic body modelling. Its consequences lead to ulceration, disfigurement and even death, and it has reached epidemic proportions in several regions of the world. We describe a series of patients treated for FMARs in a specialised wound care centre and a thorough review of the literature. A retrospective chart review was performed from January 1999 to September 2015 of patients who had been injected with non-medical foreign agents and who developed cutaneous ulceration needing treatment at the dermatology wound care centre. This study involved 23 patients whose ages ranged from 22 to 67 years with higher proportion of women and homosexual men. The most commonly injected sites were the buttocks (38·5%), legs (18%), thighs (15·4%) and breasts (11·8%). Mineral oil (39%) and other unknown substances (30·4%) were the most commonly injected. The latency period ranged from 1 week to 17 years. Complications included several skin changes such as sclerosis and ulceration as well as systemic complications. FMAR is a severe syndrome that may lead to deadly complications, and is still very common in Latin America.

Background: Most patients with oral mucosal melanoma have had a mucosal hyper pigmented area for months or even years before the diagnosis, it is important to consider the differential diagnosis of mucosal melanoma, which in many cases is a difficult diagnosis and because of the aggressive biological behavior of mucosal melanoma it is important to do a quick diagnosis. Main observation:A 40-year-old Mexican male patient, presented with a lesion on the lower right half of the lip covering almost the entire vermillion border, 1 mm below the white roll. The lesion was a 1.5 x 4 cm pigmented macule with asymmetric and irregular borders and colors. Dermoscopy showed a multi component pattern. An incision biopsy was performed under the impression of mucosal melanoma. The pathologic report described a Clark I vermillion edge mucosal melanoma in situ. Conclusions:This case had confounding clinical signs that could have misguided the clinician. But dermoscopy proved to be useful when suspecting a malignant lesion, which prompted a biopsy and a correct diagnosis. (J Dermatol Case Rep. 2012; 6(1): 1-4) A case of oral mucosal melanoma. Clinical and dermoscopic correlation.Tamar Hajar-Serviansky, Daniela Gutierrez-Mendoza, Iris L. Galvan, Lorena Lammoglia-Ordiales, Adalberto Mosqueda-Taylor, Maria de Lourdes Hernandez-Cázares, Sonia Toussaint-Caire Dermatology Division, Hospital General "Dr. Manuel Gea González", Mexico City, Mexico. IntroductionThere are many lesions that present with an increase in oral mucosal pigmentation, with an intrinsic and extrinsic origin. Since most patients with oral mucosal melanoma have had a mucosal hyper pigmented area for months or even years before the diagnosis, it is important to consider the differential diagnosis of mucosal melanoma. Case ReportA 40-year-old Mexican male patient, Fitzpatrick's skin type III, presented with a lesion on the lower right half of the lip covering almost the entire vermillion border, 1 mm below the white roll. The lesion was a 1.5 x 4 cm pigmented macule with asymmetric and irregular borders and colors. The white roll had an infiltrated area that was slightly elevated and deformed with grouped vesicles and erythema (Fig. 1).According to the patient, the lesion had always been present, and was confident the elevation and erythema were in the hard palate and upper alveolar ridge. Jaw, retromolar, trigone, and floor of the mouth were involved in 3 cases (8.57%); 3 melanomas (8.57%) were detected in the labial mucosa and 2 (5.71%) on buccal/vestibular mucosa. Only 1 case (2.86%) was diagnosed on the lateral border of tongue, and in 1 case (2.86%), they could not identify the site of the lesion. 7The biological behavior of mucosal melanoma notoriously differs from the one shown in case of skin melanomas. Likely reasons are late diagnosis and treatment; anatomic differences in location, a greater blood and lymphatic flow in mucosa, easing its spread and differences in its genetic profile. For the above, in general, it has a bad prognosis with a 5-ye...

The authors have indicated no significant interest with commercial supporters.D ermatology is now a medical-surgical specialty because of the increasing incidence of skin cancer, and skin diseases that must be treated using surgical means. Dermatologists must develop skills to treat benign and malignant lesions while maintaining function and aesthetics. To achieve this, residency programs have been urged to use novel teaching methods to train dermatologists in cutaneous surgery. Skin models that have traditionally been used for these purposes may be expensive, inaccessible, or impractical. We have developed a surgical model that is inexpensive, easily obtainable, and comparable with human skin for the training of dermatologic surgery. ObjectiveOur purpose was to demonstrate that ethylene vinyl acetate (EVA) is an inexpensive and useful tool for teaching suture techniques in dermatologic surgery. MethodsA dermatologic surgery professor gave a 60-minute theoretical and practical lecture on common surgical stitches (simple interrupted, running, horizontal and vertical mattress, interrupted buried, ''8'', three-and four-point corner, and half-buried horizontal stitches) to 15 dermatology residents. The techniques were thoroughly explained with images on color slides. The residents were then asked to draw the sutures to prove that they had learned the techniques. Afterwards, participants used EVA as a skin model to practice the sutures. The materials used included an 8-Â 6-inch sheet of EVA foam with linear incisions, a 5-0 nylon suture, and a surgical instrument kit that included forceps, needle holder, and cutting scissors. The residents were evaluated on their surgical abilities (handling of the needle holder, forceps, and foam and correct angle of entry of the needle) and the final result of the sutured incision. ResultsThe 15 residents were able to reproduce all of the stitches taught during the lecture. The consistency of the EVA allowed handling with the forceps and penetration by the needle without ripping the sheet. The thickness of the sheet allowed all of the superficial and deep stitches to be performed. Some examples are the superficial cuticular and threepoint corner stitch shown in Figures 1 and 2 and the deeper buried stitch (Figure 3). It also allowed proper eversion of the borders of the simulated linear wound. Students and professor were able to evaluate and rate the students' surgical skills with the final result. The residents showed interest and were

Background: B-Raf is a serine/threonine protein kinase activating the MAP kinase/ERK-signaling pathway. It has been shown that 50% of melanomas harbor activating BRAF mutations, with over 90% being the V600E mutation. Objective: The goal of this research was to determine the prevalence of the BRAF V600E mutation in patients from Central Mexico diagnosed with primary melanoma. Methods: Skin biopsies from 47 patients with melanoma were obtained from the dermatology department of the Hospital General ‘Dr. Manuel Gea González' in Mexico City. For BRAF mutation determination, after DNA isolation, the gene region where the mutation occurs was amplified by PCR. Subsequently, the presence or absence of the V600E mutation was detected by Sanger sequencing performed at the private molecular diagnostic laboratory Vitagénesis in Monterrey, Mexico. Results: Of the 47 patients sampled, 6.4% harbored the V600E mutation. No statistical significance was found between mutations and the type of tumor.