Nonmelanoma Facial Skin Cancer: A Review of Diagnostic Strategies, Surgical Treatment, and Reconstructive Techniques

Badash, Ido; Shauly, Orr; Lui, Christopher; Gould, Daniel J.; Patel, Ketan M.

doi:10.1177/1179550619865278

Cited by 37 publications

(34 citation statements)

References 72 publications

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“…For defects involving the nasal cartilage, the restoration of the nasal framework is crucial for maintaining nasal projection. In these cases, autologous transfer of septal, auricular, or costal cartilage should be performed 9 .…”

Section: Discussionmentioning

confidence: 99%

Reconstruction methods of the head defects after skin cancer excision – case series

Grigore¹,

Cirstea²,

BEJENARU³

et al. 2021

Arch Balk Med Union

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Méthodes de reconstruction des défauts de la tête après excision du cancer de la peau -série de casIntroduction. La chirurgie du cancer implique souvent des excisions qui conduisent à des défauts anatomiques remarquables. Les méthodes de reconstruction suite à une chirurgie ablative pour un cancer de la peau de la tête sont uniques et nécessitent une attention particulière, tant pour la forme que pour la fonction. L'utilisation de greffes de peau d'épaisseur fractionnée ou peu pleine épaisseur est indiquée pour les parties du visage avec un mouvement minimal. Présentations de cas. Nous présentons quatre cas de cancer de la peau nécessitant un lambeau pour la reconstruction des défauts post-excision. Le premier cas est celui d'un homme de 90 ans atteint d'un carcinome épidermoïde préauriculaire droit. L'ablation de la masse tumorale cutanée pré-auriculaire droite a été réalisée et le défaut restant a été reconstruit avec une greffe de peau pleine épaisseur prélevée du bras. Le deuxième cas est d'un patient de 45 ans avec un ABSTRACT Introduction. Cancer surgery often involves excisions that lead to important anatomical defects. The reconstruction methods following an ablative surgery for head skin cancer are unique and require special attention for both shape and function. Utilisation of split-thickness or full-thickness skin grafts is indicated for face regions with minimal motion. Case presentations. We present four cases of skin cancer, who required a flap for the reconstruction of post-excision defects. The first case is of a 90-year-old male with a right preauricular squamous cell carcinoma. The remaining defect after tumour ablation was reconstructed with a full-thickness skin graft harvested from the arm. The second case is of a 45-year-old male with a malignant melanoma of the scalp. The defect on the scalp was also covered with a skin graft. The third case is of a 51-year-old diabetic woman with left nasal skin cell carcinoma. The defect left after excision was reconstructed with a nasolabial flap and a free cartilage graft harvested from the concha. The fourth case is of a 65-year-old male with a basal cell carcinoma of

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Section: Discussionmentioning

confidence: 99%

Reconstruction methods of the head defects after skin cancer excision – case series

Grigore¹,

Cirstea²,

BEJENARU³

et al. 2021

Arch Balk Med Union

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“…On one hand, non-melanoma skin cancers, predominantly comprising basal cell carcinoma and cutaneous squamous cell carcinoma, originate from the keratinocytes within the epidermis and account for approximately five million new cases and 65,000 associated deaths yearly [ 10 , 11 , 12 , 13 ]. Other types of non-melanoma skin cancers include Merkel cell carcinoma, Kaposi sarcoma, dermatofibrosarcoma protuberans, primary cutaneous B-cell lymphoma, sebaceous carcinoma, and atypical fibroxanthoma, which are significantly rarer [ 13 , 14 ]. On the other hand, melanoma originates from melanocytes within the deepest layer of the epidermis and, although its prevalence is considerably lower, it has the worst prognosis, with 280,000 new cases and 60,000 associated deaths reported yearly [ 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, chemotherapy is still considered the most efficient strategy and it is widely used in most cases, with more than 200 anti-cancer drugs developed that include cytostatics, anti-hormonal drugs, recombinant proteins and antibodies for molecular targeted therapy, and supportive care drugs [ 16 , 17 , 18 ]. In the case of non-melanoma skin cancer, radical tumor excision remains the most effective approach among the available strategies [ 14 , 19 , 20 ]. However, radical excision may not be possible due to patient co-morbidities or unfavorable cosmetic defects, and non-surgical approaches, such as cryotherapy, curettage, electrodessication, topical therapy, photodynamic therapy, or radiotherapy become the only option [ 13 , 14 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…In the case of non-melanoma skin cancer, radical tumor excision remains the most effective approach among the available strategies [ 14 , 19 , 20 ]. However, radical excision may not be possible due to patient co-morbidities or unfavorable cosmetic defects, and non-surgical approaches, such as cryotherapy, curettage, electrodessication, topical therapy, photodynamic therapy, or radiotherapy become the only option [ 13 , 14 , 19 , 20 ]. By contrast, treatment of melanoma involves surgery followed by radiotherapy, immunotherapy, and chemotherapy [ 13 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

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Regenerative Wound Dressings for Skin Cancer

Pavel

Chircov

Rădulescu

et al. 2020

Cancers

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Skin cancer is considered the most prevalent cancer type globally, with a continuously increasing prevalence and mortality growth rate. Additionally, the high risk of recurrence makes skin cancer treatment among the most expensive of all cancers, with average costs estimated to double within 5 years. Although tumor excision is the most effective approach among the available strategies, surgical interventions could be disfiguring, requiring additional skin grafts for covering the defects. In this context, post-surgery management should involve the application of wound dressings for promoting skin regeneration and preventing tumor recurrence and microbial infections, which still represents a considerable clinical challenge. Therefore, this paper aims to provide an up-to-date overview regarding the current status of regenerative wound dressings for skin cancer therapy. Specifically, the recent discoveries in natural biocompounds as anti-cancer agents for skin cancer treatment and the most intensively studied biomaterials for bioactive wound dressing development will be described.

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“…4 Lesions are best managed surgically, although the recommended method differs according to risk of recurrence or metastasis. 4 Recurrence rates are lower following surgical excision and Mohs microsurgery (MMS) as compared with nonsurgical modalities, including topical therapy, curettage and electrodessication, cryotherapy, and radiation, as well as destructive modalities. 5 Standard excision with a 4-mm margin of uninvolved skin and/or biopsy to a depth of the midsubcutaneous adipose tissue with histologic margin assessment is recommended for low-risk lesions.…”

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confidence: 99%

Treatment and Outcomes for Cutaneous Periauricular Basal Cell Carcinoma: A 16‐Year Institutional Experience

et al. 2020

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Objective To report a single institutional experience with the surgical management of cutaneous periauricular basal cell carcinoma. Study Design Retrospective chart review. Setting Tertiary academic center. Methods Retrospective chart review of 71 patients diagnosed with periauricular basal cell carcinoma managed surgically from 2000 to 2016. Data were analyzed with descriptive statistics. Results The median age at diagnosis was 73.0 years (interquartile range, 13.0). Of all lesions, 2.8% (n = 2) were preauricular, 80.3% (n = 57) auricular, and 16.9% (n=12) postauricular. Auricular subsites included conchal bowl (36.6%, n = 26), helix (21.1%, n = 15), antihelix (1.4%, n = 1), peritragus (5.6%, n = 4), triangular fossa (1.4%, n = 1), external auditory canal (2.8%, n = 2), and lobule skin (1.4%, n = 1). Surgical approach included wide local excision (80.3%, n = 57), partial auriculectomy (8.5%, n = 6), and total auriculectomy or other combinations of surgical methods (11.3%, n = 8). Due to aggressive pathology, 3 cases required concurrent parotidectomy, neck dissection, ear canal sleeve resection, or mastoidectomy. In sum, 52.1% (n = 37) of cases had clear margins on first pass in the operating room; 25.4% (n = 18) required further resection; and 12.7% (n = 9) demonstrated final positive/overturned margins read as negative from the frozen sections. Reconstruction included full-thickness (25.4%, n = 18) or superficial-thickness (29.6%, n = 21) skin grafts and local flap reconstruction (25.4%, n = 18), while 5.6% (n = 4) required combinations of free flap and/or other reconstruction techniques; 14.1% (n = 10) did not undergo formal reconstruction. Conclusion Periauricular basal cell carcinoma occurs in anatomically diverse locations in and around the ear, and multiple surgical methods are required for successful treatment.

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Nonmelanoma Facial Skin Cancer: A Review of Diagnostic Strategies, Surgical Treatment, and Reconstructive Techniques

Cited by 37 publications

References 72 publications

Reconstruction methods of the head defects after skin cancer excision – case series

Reconstruction methods of the head defects after skin cancer excision – case series

Regenerative Wound Dressings for Skin Cancer

Treatment and Outcomes for Cutaneous Periauricular Basal Cell Carcinoma: A 16‐Year Institutional Experience

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