Rosacea is a chronic facial inflammatory dermatosis characterized by background facial erythema and flushing and may be accompanied by inflammatory papules and pustules, cutaneous fibrosis and hyperplasia known as phyma, and ocular involvement. These features can have adverse impact on quality of life, and ocular involvement can lead to visual dysfunction. The past decade has witnessed increased research into pathogenic pathways involved in rosacea and the introduction of novel treatment innovations. The objective of these guidelines is to offer evidence-based recommendations to assist Canadian health care providers in the diagnosis and management of rosacea. These guidelines were developed by an expert panel of Canadian dermatologists taking into consideration the balance of desirable and undesirable outcomes, the quality of supporting evidence, the values and preferences of patients, and the costs of treatment. The 2015 Cochrane review "Interventions in Rosacea" was used as a source of clinical trial evidence on which to base the recommendations.

Background Squamous cell carcinoma (SCC) is the second-most common form of non-melanoma skin cancer (NMSC). Objective To provide guidance to Canadian health care practitioners regarding management of SCCs. Methods Literature searches and development of graded recommendations were carried out as discussed in the accompanying introduction (chapter 1 of the NMSC guidelines). Results SCCs are sometimes confined to the epidermis, but they can also invade nearby tissues and, in some cases, metastasize to neighbouring lymph nodes or other organs. This chapter discusses the natural history, staging, prognosis, and management of SCC—a tumour type that is less common but typically more aggressive than BCC. For this reason, margin control is strongly preferred in treating SCCs. Conclusions Although approaches such as cryosurgery and radiation therapy may be considered for some patients, surgical excision—sometimes coupled with radiation—remains the cornerstone of SCC management. Patients with high-risk SCC may also be considered for referral to an appropriate multidisciplinary clinic.

Background: Basal cell carcinoma (BCC) is the most common malignancy. Growth of BCCs leads to local destruction of neighbouring healthy skin and underlying tissue and can result in significant functional and cosmetic morbidity. Objective: To provide guidance to Canadian health care practitioners regarding management of BCCs. Methods: Literature searches and development of graded recommendations were carried out as discussed in the accompanying Introduction. Results: Although BCCs rarely metastasize, they can be aggressive and disfiguring. This chapter describes the natural history and prognosis of BCCs. Risk stratification is based on clinical features, including the site and size of the tumour, its histologic subtype (nodular vs sclerosing), and its history of recurrence. Conclusions: Various options should be considered for BCC treatment, including cryosurgery, curettage, and topical or photodynamic approaches, as well as fixed-margin surgery and Mohs micrographic surgery. Stratification of recurrence risk for individual BCCs determines the most appropriate therapeutic course. RésuméContexte : Le carcinome basocellulaire (CBC) est le cancer le plus répandu. La croissance d'un CBC mène à la destruction locale de la peau saine environnante et des tissus sous-jacents et peut causer une morbidité fonctionnelle et cosmétique importante. Objectif : Fournir des conseils aux professionnels canadiens de la santé au sujet de la gestion des CBC. Méthode : Nous avons procédé à une étude documentaire et à l'élaboration de catégories de recommandations, comme on peut le lire dans l'introduction connexe. Résultats : Le CBC forme rarement des métastases, mais il peut être agressif et défigurant. Ce chapitre décrit l'évolution et le pronostic du CBC. La stratification du risque est fondée sur les caractéristiques cliniques, y compris l'emplacement et la taille de la tumeur, et son sous-type histologique (nodulaire ou sclérosant), et sur les antécédents de récurrence. Conclusion : Diverses options devraient être envisagées dans le traitement du CBC, y compris la cryochirurgie, le curetage et les approches topiques ou photodynamiques, ainsi que la chirurgie à marge déterminée et la chirurgie micrographique de Mohs. La stratification du risque de récurrence de chaque CBC individuel détermine le traitement thérapeutique le plus approprié.

We conclude that NMSC is common after kidney transplantation in a northern climate and these individuals require disease prevention-specific education, more vigilant surveillance and early referral and treatment.

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