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Cutaneous angiomyxomas are myofibroblastic neoplasms with locally aggressive behaviour and a high risk of recurrence. We describe a case of a solitary cutaneous angiomyxoma presenting on the nasal dorsum of a 28-year-old man, excised with Mohs surgery using permanent section control and repaired with an advancement flap. Histology showed myxoid nests of bland CD34-positive and vimentin-positive stellate and spindled cells in the deep dermis and abundant thin-walled blood vessels. An echocardiogram, performed to rule out the possibility of a cardiac myxoma with cutaneous embolisation, was normal.

Subungual pigmented lesions should raise concern about malignant melanoma. Blue naevus of the nail apparatus is a rare entity, with only ten cases described in the literature. We report a 21-year-old Hispanic woman with a slowly enlarging 1.7 x 2.3-cm subungual and periungual pigmented plaque present since birth on her right second toe. Initial biopsy was consistent with a blue naevus of the cellular type and, given the recent clinical change and periungual extension, complete excision was recommended. The entire nail unit was resected down to periosteum with prior avulsion of the nail plate. Reconstruction was performed with a full-thickness skin graft. Follow up at 1 year revealed well-healed graft and donor sites with complete return of function. We present a case of a congenital subungual and periungual blue naevus of the cellular type and review the literature on this rare presentation of a congenital blue naevus.

The helical rim is often affected with cutaneous malignancies and requires special attention in the repair, owing to the complex cartilaginous contour, preservation of the aesthetic contour and restoration of its supportive function for eyeglasses and hearing aids. We review the surgical technique of chondrocutaneous advancement flap described by Antia and Buch as one of the most cosmetically appealing and versatile approaches for the repair of small defects of the ear helix.

Although Mohs micrographic surgery is the standard of care for large, aggressive or recurrent non-melanoma skin cancers of the head and neck, tumours that involve deep underlying structures (including bone, parotid gland and named nerves) are impractical for extirpation under local anaesthesia. Such cases are often referred to a head and neck surgeon, who typically relies on intraoperative frozen section analysis of the peripheral cutaneous margin. Here we describe the use of the Mohs moat technique as part of a collaborative approach for the treatment of aggressive and deeply invasive basal cell carcinoma that allows an analysis of the complete peripheral cutaneous margin and results in decreased operating room and general anaesthesia time.