BACKGROUND The American Society for Dermatologic Surgery (ASDS) International Traveling Mentorship Program (ITMP) has initiated an International Mohs Fellowship Recognition Program, with 3 centers accredited to date. OBJECTIVE To describe and compare the outcomes of Mohs micrographic surgery (MMS) at the three units. METHODS From patient files, we extracted demographic information, as well as tumor type, location of tumor, tumor histology, stages of MMS, and outcomes. RESULTS At the 3 units, 3,899 patients were treated with MMS over a 5-year period in the South African unit, and 1,141 cases in the Romanian unit. Over a 3-year period, 849 cases were treated in the Netherlands unit. Basal cell carcinomas (BCCs) constituted 78.9% (South African unit), 79% (Romanian unit), and 97.2% (Netherlands unit), and squamous cell carcinomas (SCCs) 17.7% (South African unit), 19% (Romanian unit), and 0.7% (Netherlands unit) of the tumors treated. The recurrence rate following MMS was low, at 0.1% (South African Unit) and 0.17% (Romanian Unit) of cases at the end of the study period, with a median follow-up time of 2 years. CONCLUSION Mohs micrographic surgery is an effective treatment modality for removing BCC and SCC at ASDS ITMP–recognized International Mohs Fellowship units.

Introducere: Cancerele de piele au o incidenţă în continuă creştere, avand un impact economic important. Microchirurgia Mohs este cunoscută ca gold-standard în tratamentul a 10 tipuri de tumori cutanate, dintre care carcinoamele bazocelulare şi spinocelulare sunt cele mai frecvent întâlnite. Metodă: Au fost analizate dosarele pacienţilor trataţi prin microchirurgie Mohs pe o perioadă de 6 ani (2014-2019) şi au fost extrase informaţii demografice, precum şi informaţii despre histologia tumorală, localizarea tumorilor, numărul de stadii necesare pentru îndepărtarea completă a tumorii şi evoluţia pacienţilor. Am analizat informaţiile cu privire la numărul şi tipul de reconstrucţii efectuate. Rezultate: Pe parcursul a 6 ani, în clinica noastră au fost tratate 1356 tumori cutanate folosind microchirurgia Mohs. Carcinoamele bazocelulare au reprezentat 80.5%, carcinoamele spinocelulare 17.6% iar alte tumori precum melanoamele in situ, dermatofibrosarcoma protuberans, boala Paget extramamară, carcinom sebaceu -1.9% din numărul tumorilor tratate. În perioada analizată s-au înregistrat doar 4 recidive după microchirurgia Mohs, cu o rată de vindecare de peste 99,7% Concluzii: Microchirurgia Mohs este o metodă eficientă de tratament în îndepărtarea carcinoamelor cutanate precum si a unor tumori cu indicatie speciala,cu o rată scăzută a recidivelor, reducând necesitatea unor intervenţii chirurgicale succesive.

Background: Brooke–Spiegler Syndrome is a rare genetic autosomal dominant disorder with variable penetrance. Its main feature consists of the development of multiple adnexal tumors that originate from the follicular-sebaceous-apocrine unit, most commonly: cylindromas, trichoepitheliomas and spiradenomas. Case presentation: We present four cases of Brooke–Spiegler Syndrome found in our clinic, as well as their clinicopathological traits and the surgical techniques used in their management. The familial history of three of the presented cases supports the genetic component of the disease. Cylindromas, spiradenomas and trichoepitheliomas coexisted in one of the cases presented. The therapeutic options used were electrocautery, CO2 laser, as well as tumor debulking followed by closure with metal staples. Discussion: The treatment remains a challenge and must be individualized based on the type, location and number of the lesions. Conservative methods such as CO2 laser and tumor debulking accompanied by closure with metal staples remain a viable option taking into account the large number of lesions. As patients usually develop multiple neoplasms throughout their lifetime, repeated procedures may be needed. Conclusion: Considering the few numbers of Brooke–Spiegler syndrome cases in the current literature, the authors report these patients in order to increase awareness and to help establish the most appropriate approach in managing the disease.

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Dermoscopy is a non-invasive method of examination that aids the clinician in many ways, especially in early skin cancer detection. Melanoma is one of the most aggressive forms of skin cancer that can affect individuals of any age, having an increasing incidence worldwide. The gold standard for melanoma diagnosis is histopathological examination, but dermoscopy is also very important for its detection. To highlight the many roles of dermoscopy, we analyzed 200 melanocytic lesions. The main objective of this study was to detect through dermoscopy hints of melanomagenesis in the studied lot. The most suspicious were 10 lesions which proved to be melanomas confirmed through histopathology. The second objective of this study was to establish if dermoscopy can aid in estimating the Breslow index (tumoral thickness) of the melanomas and to compare the results to the histopathological examination. We found that the tumoral thickness may be estimated through dermoscopy, but the histopathological examination is superior. To conclude, the aim of this study was to showcase the versatility and many roles of dermoscopy, besides being one of the most important tools for early melanoma diagnosis.