Cutaneous Malignancies

Mohs Micrographic Surgery, an advanced treatment procedure for skin cancer, offers the highest potential for recovery--even if the skin cancer has been previously treated. This procedure is a state-of-the-art treatment in which the physician serves as surgeon, pathologist, and reconstructive surgeon. It relies on the accuracy of a microscope to trace and ensure removal of skin cancer down to its roots. This procedure allows dermatologists trained in Mohs Surgery to see beyond the visible disease and to precisely identify and remove the entire tumor, leaving healthy tissue unharmed. This procedure is most often used in treating two of the most common forms of skin cancer: basal cell carcinoma and squamous cell carcinoma. The cure rate for Mohs Micrographic Surgery is the highest of all treatments for skin cancer--up to 99 percent even if other forms of treatment have failed. This procedure, the most exact and precise method of tumor removal, minimizes the chance of regrowth and lessens the potential for scarring or disfigurement

Photon Radiation Therapy for Skin Malignancies is a vital resource for dermatologists interested in radiation therapy, including the physics and biology behind treatment of skin cancers, as well as useful and pragmatic formulas and algorithms for evaluating and treating them. Dermatology has always been a field that overlaps multiple medical specialties and this book is no exception, with its focus on both dermatologists and radiation oncologists. It is estimated that between 2010 and 2020, the demand for radiation therapy will exceed the number of radiation oncologists practicing in the U.S. tenfold, which could profoundly affect the ability to provide patients with sufficient access to treatment. Photon Radiation Therapy for Skin Malignancies enhances the knowledge of dermatologists and radiation oncologists and presents them with the most up-to-date information regarding detection, delineation and depth determination of skin cancers, and appropriate biopsy techniques. In addition, the book also addresses radiation therapy of the skin and the skin’s reactions to radiation therapy.

Skin cancer is the most commonly diagnosed cancer in the United States, yet most cases are preventable. Every year in the United States, nearly 5 million people are treated for skin cancer, at an estimated cost of $8.1 billion. Melanoma, the most deadly form of skin cancer, causes nearly 9,000 deaths each year. Despite recent efforts to address risk factors, skin cancer rates continue to rise. While those with lighter skin are more susceptible, anyone can get skin cancer—and it can be serious, even deadly. Almost all of the conditions can be caused by unnecessary ultraviolet (UV) radiation exposure, usually from excessive time in the sun or from the use of indoor tanning devices. It is alarming that every year, nearly one out of every three young white women aged 16–25 engages in indoor tanning. It's important to shatter the myth that tanned skin is a sign of health. And a “base” tan is not a “safe” tan. Tanned skin is damaged skin. Understanding the risk of UV exposure is crucial to protecting ourselves and our loved ones. That is why “The Surgeon General's Call to Action to Prevent Skin Cancer” is important for all of us. It outlines action steps we can all take—as individuals, parents, educators, employers, policy makers, health care professionals, and communities—to reverse this alarming trend. As a nation, we can all do more to address skin cancer as a serious public health challenge. Everyone is urged to find out more about the risk of skin cancer—and what we all can do to prevent it.

The incidence of skin cancer has risen rapidly in recent decades, and patients often present initially to practitioners in many different specialties. Because skin cancer can vary in clinical appearance, even dermatologists may experience difficulty in reaching a clinical diagnosis. For primary care physicians and physician extenders (physician assistants, nurses, and nurse practitioners), who have had very little or no formal training in dermatology, the task can be still more daunting. In this atlas, the authors set out to provide a practical resource that will help improve the 'visual vocabulary' of physicians and physician extenders, helping them identify lesions that should be biopsied. Hundreds of high-quality color images are included to assist the reader in the task of recognition and identification. All of the common cutaneous malignancies are illustrated, with a number of examples of each entity and of common mimickers. In addition, biopsy techniques and treatment options are presented in step-by step detail with the use of high resolution clinical images, and potential complications of treatment are discussed. This atlas is ideal for all providers who wish to sharpen their clinical acumen and gain confidence in identifying skin cancers.

Non-melanoma skin cancer is a global public health issue. With an ever-increasing, and ageing, world population coupled with increasing numbers of immunosuppressed individuals the number of patients continues to rise. The head and neck is overwhelmingly the most frequent location for the development of a non-melanoma skin cancer and as such challenges the clinician with its complex anatomy. The importance of maintaining the aesthetics of the face and the function of the anatomy cannot be overstated, yet ultimately it is always the aim of curing a patient with the minimum of morbidity that clinicians strive for. However, the spectrum of presentations and subsequent management varies widely, ranging from patients with the ubiquitous low-risk mid-face basal cell carcinoma to those diagnosed with relatively uncommon but potentially life-threatening high-risk squamous cell carcinomas (e.g. involving metastatic lymph nodes or with perineural invasion present) and Merkel cell carcinomas.

The skin, uniquely positioned at the interface between the human body and the external world, plays a multifaceted role in the expression of cancer. Primary skin cancer is the most common cancer afflicting mankind and is rising in inci dence, despite the fact that it is often preventable. Besides primary cancer, the skin may show direct and indirect evidence of internal cancer, thus serving as a window to the body for both laymen and physicians alike. In addition, the acces sibility of the skin is useful for the study of carcinogenesis as well as cancer treat ment options. lowe much of my interest in skin cancer to Dr. Leon Goldman, the father of dermatologic laser surgery, and to Dr. Edmund Klein, the father of modern immunotherapy. We, at the Roswell Park Memorial Institute, were indeed for tunate to have a wealth of patients available for study. Many of the illustrations used in this book were of my patients at the Institute, and I kindly thank the fol lowing publications and their respective publishers for allowing me to reuse some of my photographs, most notably: Cancer Medicine (2nd edition), Journal of Surgical Oncology, Journal of the American Academy of Dermatology, Archives of Dermatology, Cancer, and Journal of Dermatologic Surgery and Oncology. We are very fortunate in this work to have some of the world's foremost authorities in their areas as contributors, such as Drs. Zackheim, Lambert, J.W. Trimble, J.R. Trimble, Jackson, Crutcher, Mashberg, Wick, Sidell, F. Helm, G.

The treatment of skin cancer has become an increasingly multispecialty practice. Ongoing surgical and postsurgical advances and emergent factors that predispose patients to these tumors have changed the treatment paradigm. Having a keen understanding of diagnostic, surgical, and nonsurgical treatment options is key to identifying, treating, or referring patients with potential cutaneous malignancies. While Brian R. Gastman's Cutaneous Malignancies: A Surgical Perspective is the first of its kind to emphasize surgical management of skin cancer, several sections are devoted to systemic nonsurgical therapies affecting patient care and surgical intervention. Topics encompassed include prevention, diagnosis, medication management, appropriate margin size, reconstruction methods, and the importance of stellar dermatopathology. Key Highlights The role of Mohs micrographic surgery and radiation in skin cancer treatment Treatment approaches for the two most common forms of skin cancer respectively, basal cell carcinoma and squamous cell carcinoma Surgical treatment of cutaneous malignant melanoma and other high-risk malignancies Clinical insights on completion lymphadenectomy and sentinel node biopsy for melanoma, two topics rarely addressed in context with skin cancer Diagnosis and treatment of rare malignancies including Merkel cell carcinoma, dermatofibrosarcoma protuberans, cutaneous angiosarcoma, and cutaneous leiomyosarcoma More than 400 high-quality illustrations further delineate surgical modalities Edited by an esteemed dual board certified plastic surgeon and otolaryngologist, this definitive book is the most complete guide to surgical management of skin cancer. It is essential reading for plastic surgeons, dermatologists, otolaryngologists, and all clinicians who treat or refer patients with suspected skin cancer.