Evidence-Based Medicine

Abstract

Skin lesion excision is the most common procedure performed by plastic surgeons. Because of the cumulative risk factors of sun and carcinogen exposure, the head and neck are the most frequently affected regions of the body. Timely diagnosis and treatment are critical for preventing continued spread and metastasis, and it is incumbent on the treating physician to make the appropriate recommendations for surgical margin and the possibility of adjuvant therapy to prevent recurrence and optimize long-term survival. As clinical guidelines are developed from ongoing outcome studies, new generations of treatment recommendations are continuously in development. Therefore, a systematic review of the most relevant guidelines and clinically rigorous studies was performed with a summarization of treatment recommendations for the following: actinic keratosis, Bowen disease (squamous cell in situ), basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and Merkel cell carcinoma of the head and neck.

A Retrospective Clinical View of Basal Cell Carcinoma and Squamous Cell Carcinoma in the Head and Neck Region: A Single Institution's Experience of 247 Cases over 19 Years

“…In the present study, the mean tumor diameters was 1.15 cm for BCC and 1.65 cm for SCC, and the mean onset-to-diagnosis times was 3.2 and 1.9 months for BCC and SCC, respectively. Typically, SCC is more aggressive in terms of invasion and metastasis than BCC [ 1 ], and our results represent the more aggressive characteristics of SCC.…”

“…Skin cancer is the most common type of cancer and affects over 2 million people annually in the United States [ 1 , 2 ]. Skin cancers are distinguished by the type of cells that give rise to each lesion, and consist of basal cell carcinoma (BCC) (77%), squamous cell carcinoma (SCC) (20%), malignant melanoma (3%), and rare tumors of cutaneous origin (<1%) [ 3 , 4 ].…”

“…Skin cancers are distinguished by the type of cells that give rise to each lesion, and consist of basal cell carcinoma (BCC) (77%), squamous cell carcinoma (SCC) (20%), malignant melanoma (3%), and rare tumors of cutaneous origin (<1%) [ 3 , 4 ]. Anatomic distribution is heavily skewed towards head and neck area for skin cancers, as 85% of BCCs and 75% of SCCs occur in this region [ 1 ].…”

“…BCC is characterized by slow growth and rare metastasis [ 1 , 4 ], whereas SCC is typically more aggressive with respect to invasion and metastasis [ 1 ]. Many factors influence the development of BCC and SCC, with sun exposure being the most prominent factor [ 1 , 4 , 5 ].…”

“…Currently, the population experiences incidences of 0.25% and 0.34% for BCC and SCC, respectively [ 6 ]. Among various methods of treating BCC and SCC, wide local excision with frozen section or Mohs surgery is the standard, as each of these options minimizes local recurrence [ 1 4 5 ].…”