Occurrence of two or more skin tumors closely situated to each other is not so rare in clinical dermasurgical practice. Excision of multiple contiguous skin lesions can represent a major dermasurgical problem that can be solved in different surgical times. However, in our opinion, the best therapeutic solution is to carry out the removal in a single surgical session; this choice allows saving time, an easier plastic reconstruction, and better esthetic results. Many different reconstructive procedures can be designed and applied, to achieve the best result. The simplest Burow’s triangle flap permits excision of two contiguous lesions with less tension compared to two fusiform cuts, but many other plastic solutions can be chosen to satisfy the needs of different anatomical sites and according to skin features. In the author’s personal experience, of about 8000 patients who have undergone dermatologic surgery over the past 20 years, the presence of multiple contiguous lesions occurred in about 200 cases. In all of these, triangle, rotation, advancement, or transposition flaps allowed simultaneous removals, saving time and money and giving better esthetic results compared to multiple direct excision carried out at successive times. In this chapter, the different techniques are described and illustrated in detail.
Part of the book: Dermatologic Surgery and Procedures