Mohs Micrographic Surgery for Cutaneous Squamous Cell Carcinoma.

BACKGROUND The first-line treatment of the localized form of cutaneous squamous cell carcinoma (cSCC) remains surgical excision. Either conventional excision (CE) with margins or Mohs micrographic surgery (MMS) may be preferred, depending on the risk factors of cSCC, the characteristics of the tumor, and the available technical facilities. METHODS This article presents a systematic review of the current literature spanning from 1974 to 2023, comparing outcomes of cSCC treated with MMS versus cSCC treated with conventional excision. RESULTS Out of the 6821 records identified through the database search, a total of 156 studies were screened, of which 10 were included in the review. The majority of the included studies showed that treatment of cSCC with MMS consistently exhibits a significantly lower risk of recurrence compared to treatment with CE. In addition, MMS is emerging as the preferred technique for the resection of cSCC located in aesthetically or functionally challenging anatomical areas. CONCLUSION The studies generally demonstrate that MMS is a safer and more effective treatment of cSCC than CE. Nevertheless, outcomes such as recurrence rates and cost-effectiveness should be assessed more precisely, in order to allow for a more tailored approach in determining the appropriate indication for the use of MMS

Characteristics of dermatological patients with blood eosinophilia: a retrospective analysis of 453 patients.

BACKGROUND Skin diseases associated with blood or tissue eosinophilia are common. As their clinical manifestations are various, making the correct diagnosis can be challenging. So far, dermatological patients with concomitant blood eosinophilia have not been characterized. OBJECTIVE We aimed at investigating patterns of dermatological patients with concomitant blood eosinophilia in order to obtain information helpful for optimizing disease management. METHODS In this retrospective study, demographic and clinical data and diagnostic test results of all patients presenting with dermatoses associated with blood eosinophilia (DABE) referred to a university center from 2014 to 2018 were extracted from the electronic patient charts and evaluated using descriptive and semantic map analyses. RESULTS A total of 453 patients (51.4% females; mean age 58.4 ±21.7 years) were included and grouped according to blood absolute eosinophil counts: severe, ≥1.5 G/L (n=87; 19.2%), moderate, 1.0 - 1.49 G/L (n=73; 16.1%), and mild eosinophilia, 0.5 - 0.99 G/L (n=293; 64.7%). Most patients presented with chronic (64.6%), generalized skin lesions (75.9%), and pruritus (88.1%). Statistical analyses revealed three distinct patterns: 1. mild eosinophilia associated with localized skin disease, age 70 years, and autoimmune bullous disease, and 3. severe eosinophilia associated with diagnosis of hypereosinophilic syndromes, drug hypersensitivity or malignant disesase. CONCLUSIONS Based on the pattern analysis of patients with DABE, a diagnostic workup has been developed aiming at setting the correct differential diagnosis in a feasible and effective manner