Invasive cutaneous squamous cell carcinoma (cSCC) is a common skin cancer in the white populations accounting for 20% of keratinocyte carcinomas. The first-line treatment for primary cSCC is surgical excision with postoperative margin assessment or microscopically controlled surgery. In the elderly with multi-morbidities the treatment should be carefully pondered, in order to gain oncologic safety with the minimal invasiveness and related complications. We faced a cSCC of the nose in 86-year-old man with an advanced approach, combining Mohs’ surgery with a biologically engineered material (the double layer dermal regenerative matrix Integra®) and subsequent skin graft. This technique offers a novel valid surgical and reconstructive option, decreasing the duration of hospitalization and avoiding secondary morbidity and complications with otherwise excellent postoperative cosmetic and functional results and oncologic safety.

Keywords: Skin cancer; Dermal regenerative template; Mohs' surgery