BACKGROUND. Antibiotics are often prescribed in perioperative settings, including dermatologic surgery. Given the continued evolution in the breadth and complexity of cutaneous procedures performed and inevitable localized or distant infections that occasionally occur, it seems prudent to periodically evaluate findings and recommendations from the literature regarding the use of antibiotics in cutaneous surgery.

have indicated no significant interest with commercial supporters. Case ReportA 68-year-old gentleman presented to the Veterans Administration dermatology clinic with a severalweek history of a new growth on the left ear ( Figure 1). The lesion was asymptomatic and the patient denied previous treatment to the area. He was feeling constitutionally well. Physical examination revealed a 1.0-cm pink to brown shiny opalescent crusted nodule on the left ear, spanning the midhelix and antihelix. Adenopathy was not appreciated. The initial clinical differential diagnosis included basal cell carcinoma, amelanotic malignant melanoma, and Merkel cell carcinoma. A deep shave biopsy was performed.Histologic evaluation revealed an atypical spindle cell proliferation with pleomorphic nuclei and scattered atypical mitoses infiltrating the dermis (Figures 2 and 3). Immunohistochemistry showed strong positivity for smooth muscle actin and vimentin. Desmin was focally positive. Pankeratin, S100, and Mart-1 staining were negative.A histologic diagnosis of cutaneous leiomyosarcoma was made. Excision of the primary lesion was performed. Lateral surgical margins extended 5 mm beyond the clinical boundary of the lesion, and the deep margin extended to the posterior aspect of the auricular cartilage. Clear surgical margins were confirmed histologically. A porcine xenograft Figure 1. Clinical photograph.Figure 2. Low-power magnification demonstrates an atypical spindle cell proliferation infiltrating the entire dermis. H&E; original magnification, 4 Â .

HVOCA tissue adhesive is cosmetically equivalent to epidermal sutures in the linear repair of facial wounds following MMS. This technique represents an additional option for Mohs surgeons.

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BACKGROUND Manual dermabrasion with sterile sandpaper has been used for many years for skin surface retexturing. Owing to recent policy changes, our institution no longer allows sterilization of sandpaper. The electrocautery scratch pad is a routine component of our surgical tray and is presterilized by the manufacturer. OBJECTIVE The purpose of this study was to correlate the histologic effectiveness and ultrastructural properties of the electrocautery scratch pad to different samples of sandpaper shown to be effective for manual dermabrasion. METHODS An ex vivo pig foot model was used. Histologic samples from each area abraded and a control were sent for measurement of depth of abrasion. Ultrastructure of all abrading materials was compared by high‐magnification photographs. RESULTS: All abrading materials used except for the smallest grit sandpaper reached approximately the same histologic depth while using the same amount of strokes and approximately the same pressure. Ultrastructurally, the surface of the scratch pad was slightly more abrasive than the 100‐grit sandpaper, but less abrasive than the 60‐grit sandpaper. CONCLUSION The electrocautery scratch pad provides an effective alternative to traditional sandpaper for manual dermabrasion.