نبذة مختصرة : Purpose: Basal cell carcinoma of the skin often affects the head and neck area. In elderly male patients with androgenic alopecia, the scalp is a zone of cancerization, often suffering from keratinocyte tumors. After surgical excision, extensive round and oval defects are common, and in these cases, reconstructive surgery is needed. This is a serious challenge for dermatosurgeons, surgical oncologists and reconstructive surgeons since the scalp has limited skin mobility and the skin elasticity decreases with age. Multiple graft and flap techniques have been described, and they often lead to long scars and edge necrosis. Material/Method: We present a 74-year-old patient diagnosed with basal cell carcinoma affecting the frontal region of the middle scalp line with a diameter of 35mm. Artificial intelligence dermoscopy was performed with a 95% malignancy rate. The lesion was excised with a safety peripheral zone of 6mm from the dermatoscopically visible edges on each side, creating a defect with diameter of 50 mm, reaching in depth to the galea aponeurotica. A-T advancement flap was performed for reconstruction of the defect with a satisfactory functional outcome. Results: In the follow-up period, there was no bleeding, necrosis, or other complications. We assessed optimal functional and cosmetic postoperative effect. Conclusion: In the literature, a variety of procedures for scalp reconstruction have been described. In patients with extensive tissue loss, advancement flaps, like the A-T flap, are most commonly used. This advancement flap technique is practical and safe with good structural and aesthetical effect.
Processing Request
No Comments.