DOI: 10.36347/sasjs.2022.v08i08.007

Pages: 530-540

Skin cancers are a real scourge and a public health problem in our country. This facial localization in its advanced form is a source of aesthetic, functional, and life-threatening after-effects, which defines their seriousness and the difficulties of management both for carcinological excision and reconstruction. From a retrospective study spread over a period of 16 months, collected in the department of reconstructive and plastic surgery of the CHU Tanger Tetouan Al Hoceima, we analyzed the clinical and histological epidemiological characteristics, the time of diagnosis, the type of therapy, and the fate of 25 patients. The age of our patients ranged from 9 to 83 years with an average age of 53 years and a male predominance (sex ratio = 1.5). Rural origin represented 72% and the majority of the professions were exposed to the sun. All regions of the face were involved with a concentration of lesions in the midface (60%). Xeroderma pigmentosum was the most common precancerous condition (16%). Basal cell carcinoma was the most frequent histological type (60%), followed by squamous cell carcinoma (36%) and melanoma (4%). The macroscopic appearance of the tumors was ulcerative in the majority of cases (52%). Tumors were classified as T4 in 48%. Tumor removal was the rule in all our patients, with a safety margin adapted to the histological type and tumor size. A lymph node curage was performed in 6 patients. An exenteration was performed on 6 patients. A parotidectomy was performed on 1 patient. The repair was adapted to the location and extent of the defect. Reconstruction was deferred in 64% of cases and involved direct sutures in 3 cases, skin grafts in 7 cases, and essentially loco-regional flaps in 15 cases. The carcinological evolution was marked by recurrences in 2 patients with 3 cases of pulmonary and bone metastases. Finally, the therapeutic strategy can only be established and thought out on a case-by-case basis, using all the means at our disposal: .......