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Background: Mohs micrographic surgery is worldwide used for treating skin cancers. After obtaining tumor-free margins, choosing the most appropriate type of closure can be challenging. Objectives: Our aim was to associate type of surgical reconstructions after Mohs micrographic surgery with the characteristics of the tumors as histological subtype, anatomical localization and especially number of surgical stages to achieve complete excision of the tumour. Methods: Transversal, retrospective analyses of medical records. Compilation of data such as gender, age, tumor location, histological subtype, number of stages to achieve clear margins and type of repair used. Results: A total of 975 of facial and extra-facial cases were analyzed. Linear closure was the most common repair by far (39%) and was associated with the smallest number of Mohs micrographic surgery stages. This type of closure was also more common in most histological subtypes and anatomical locations studied. Using Poisson regression model, nose defects presented 39% higher frequency of other closure types than the frequency of primary repairs, when compared to defects in other anatomic sites (p< 0.05). Tumors with two or more stages had a 28.6% higher frequency of other closure types than those operated in a single stage (p< 0.05). Study limitations: Retrospective study with limitations in obtaining information from medical records. The choice of closure type can be a personal choice. Conclusions: Primary closure should not be forgotten especially in surgical defects with fewer stages and in non-aggressive histological subtypes in main anatomic sites where Mohs micrographic surgery is performed.

Background/Aim: Non-melanoma skin cancer (NMSC) is the most prevalent type of cancer in adults. Surgery remains the golden-standard treatment for this disease. Mohs micrographic surgery (MMS), a surgical technique, is based on the three-dimensional histopathological examination of the margin and surgical bed, layer by layer, in the excised tissue allowing for the determination of the location of the residual tumor, for its complete excision, with high cure rates and preservation of the unaffected tissue. The aim of this study was to present the epidemiological characteristics of the population that was submitted to MMS, as well as, correlate these characteristics with the characteristics of the tumor itself and the surgical procedure. Patients and Methods: A retrospective cross-sectional study was conducted over a 10-year period with an analysis of patient medical records submitted for MMS at the Department of Dermatology of the ABC School of Medicine. Data were presented and evaluated by non-parametric and parametric analyses, using absolute and relative frequency values for the continuous variable, to which a Chi-square test was applied for the verification of power with a significance level of 5%. For the independent variables, the Student’s t-test was used to compare means, with a confidence interval (CI) ranging from 95 to 99%, and Friedman’s test was used to verify if there were significant differences in the variables of interest. Results: Female patients accounted for 67% of all enrolled patients (n=335). The mean age was 67 years (SD±12.04; median=68; range=25-93 years). The predominant skin phototype (Fitzpatrick's classification) was phototype II (n=228, 46%). All procedures were performed under local anesthesia. Flap reconstruction was the most predominant surgery type (n=17, 68%). The mean number of MMS’s stages was 1.6 (range=1-8). There was a mean of 3.8 fragments of skin tissue (range=1-29) per stage. The mean tumor size was 30 mm (92%). This was associated with female sex (p=0.03), H-zone area (p

Background Hyaluronic acid fillers are used for facial rejuvenation and are classified as non-cross-linked or cross-linked (monophasic mono- or polydensified). Objectives To histologically assess the intradermal durability of three types of fillers (biphasic, monophasic monodensified, and monophasic polydensified), to compare the durability of the products over 6 months, and to evaluate the structural changes after application. Methods In all, 25 volunteers received injections of three different fillers in the dermis of the right lumbar region (in one line), and equal amounts of the fillers were injected into three different sites (in the same column), yielding nine points of application in each patient. Each line was biopsied on days 2, 92, and 184; these skin samples were analyzed histologically, and the presence or absence of these fillers was verified by a dermatopathologist. Results The histological analysis showed that over 182 days, the amount of the injected monophasic polydensified, monophasic monodensified, and biphasic filler products decreased by 62.5%, 25%, and 12.5%, respectively. Conclusions The biphasic and monophasic monodensified fillers presented greater intradermal durability than did the monophasic polydensified filler at 6 months after intradermal injection. Level of Evidence 2

OBJECTIVES: Dengue has become the most important endemic disease in Brazil. The Amazonian state of Roraima has one of the highest incidence rates of dengue in the country. The objective of this study was to determine whether significant temporal relationships exist between the number of reported dengue cases and short-term climate measures for the city of Boa Vista, the capital of Roraima. If such relationships exist, that suggests that it may be possible to predict dengue case numbers based on antecedent climate, thus helping develop a climate-based dengue early-warning system for Boa Vista. METHODS: Seasonal Pearson product-moment correlations were developed between 3-week running averages of daily numbers of reported dengue cases for September 1998-December 2001 and certain meteorological variables (thermal, hydroclimatic, wind, atmospheric pressure, and humidity) up to 25 weeks before. Two-sample t tests were also applied to test for statistically significant differences between samples of daily dengue cases with above-average values and samples with below-average values for three-variable meteorological combinations. These multivariate combinations consisted of the three climate measures that together explained the greatest portion of the variance in the number of dengue cases for the particular season. RESULTS: The strength of the individual averaged correlations varied from weak to moderate. The correlations differed according to the period of the year, the particular climatic variable, and the lag period between the climate indicator and the number of dengue cases. The seasonal correlations in our study showed far stronger relationships than had daily, full-year measures reported in previous studies. Two-sample t tests of multivariate meteorological combinations of atmospheric pressure, wind, and humidity values showed statistically significant differences in the number of reported dengue cases. CONCLUSIONS: Relationships between climate and dengue are best analyzed for short, relevant time periods. Climate-based multivariate temporal stochastic analyses have the potential to identify periods of elevated dengue incidence, and they should be integrated into local control programs for vector-transmitted diseases.