Asymptomatic erythematous plaque of the chin.

Abstract

The presence of an erythematous plaque, asymptomatic, slowly growing for 10 years, with little visible margins, in the aesthetic area of the chin of a beautiful and young woman arises issues in relation to the best method to be used for healing. First, we performed a biopsy to confirm the diagnostic suspicion of morpheaform basal cell carcinoma, in order to justify the type of subsequent surgery which the very anxious patient did not really think to face. With the histological confirmation we performed the surgical excision with delayed closure of the surgical wound, waiting for the histological response. When this arrived with free margins and bottom, the surgical wound was closed with a double U-shaped flap. The Burow triangle was only incised in the submandibular area to minimize the scar. During surgery, the patient was also seized by a panic attack: she began to agitate, scream, tear off the operating cloth and wanted to get off the operating table with the open wound. The episode was controlled with oxygen therapy and sedation for IV. and has led us to accelerate the closing times with less attention to keep the operating field clean from blood and blood crusts. Even if the delayed closure of a surgical wound offers nevertheless a greater guarantee of healing, it will require a longer healing time, and it will also cause a lower aesthetic outcome