Non-Surgical Treatment
Superficial Radiotherapy: Long Term Follow-Up of Highly Selected Basal and Squamous Cell Carcinomas in Skin Cancer Patients
Superficial radiotherapy (SRT) treatment for non-melanoma skin cancer has been reported to yield variable cure rates. When patients are highly selected, adequate margins of treatment are chosen, and hypofractionation is avoided, cure rates of SRT can approach that of Mohs surgery. SCARS Center’s research article on the subject was recently published in Journal of Dermatology…
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Chronic Open Wound Management with Wound Vac
Chronic open wounds present a lifestyle challenge for patients. In particular, lower leg wounds can take months to fully heal and may require wound care to prevent infection and maintain a healthy, healing wound. A wound vac or “vacuum-assisted closure of wound” can expedite healing. A wound vac decreases the air pressure on the wound…
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Augmenting Efficacy of Topical 5-FU for Actinic Keratoses and Skin Cancer
Diffuse actinic sun damage can present a challenge for both patients and providers. First line treatment options include topical 5-fluorouracil (5-FU) cream or photodynamic therapy (PDT). Topical 5-FU cream is applied to the affected area for 2-3 weeks creating inflammation, redness, and crusting as the body eliminates the actinic damage. Alternatively, topical levulan is applied…
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When to do Curettage and Electrodessication (C&D)
HISTORY A 95-year-old woman presents with a 4+ year history of multiple growing lesions of forehead and scalp. These were initially asymptomatic and the patient chose not to seek treatment. She did not present for evaluation and treatment until 2 of the lesions became painful and began to bleed. Shave biopsy of 2 of the…
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A Simple Cream for Cancer with Not Always Simple Consequences
HISTORY A 62-year-old woman presents with multiple hypopigmented areas of previous skin cancer treatment with imiquimod. DISCUSSION Some patients find themselves with a large number of skin cancers and pre-cancerous lesions. While surgical excision is recommended for certain types of skin cancer, pre-cancers and superficial skin cancers can often be treated in other ways. These…
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Managing Eyelid Skin Cancer
HISTORY A 53-year-old man presented with an approximately 10-year history of right upper eyelid “psoriasis.” He was treated with alclometasone dipropionate 0.05% ointment which helped with redness but flaking was still present. Trial of Protopic 0.1% ointment on 1/23/20 with minimal relief. Punch biopsy of the right upper eyelid on 5/19/21 showed inflamed AK. Area…
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The Rare Skin Cancers: Sebaceous Carcinomas
HISTORY A 67-year-old man presents w/ a painful right cheek scar s/p Mohs and reconstruction of sebaceous carcinoma done on 4/2019 complicated by salivary fistula. History of drained hematoma and leaking parotid gland s/p surgery. 0.3cc of kenalog 10 mg/cc injected on 9/30/21. Excision of right cheek scar with reconstruction done on 11/29/21. DISCUSSION Sebaceous…
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Severe Lichenoid Drug Eruption from Pembrolizumab
HISTORY An 88-year-old woman with a six-month history of a diffuse, pruritic eruption that includes thick, hypertrophic leg lesions with accompanying edema, ulcerations, weeping exudates and pain. The eruption started during a course of pembrolizumab (keytruda) infusions for high risk melanoma of the left great toe. Last Keytruda infusion was three months ago. DISCUSSION Pembrolizumab,…
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Multiple Cutaneous Carcinomas in Organ Transplant Recipients
HISTORY A 73-year-old kidney transplant recipient presented with multiple carcinomas including SCC, SCC in situ, and BCC of the face and scalp. DISCUSSION Organ transplant recipients can suffer from multiple cutaneous carcinomas. Some lesions can have a high risk of metastases, but most occur in multitudes in areas of extensive sun exposure. At SCARS Center,…
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Intralesional 5-fluorouracil for Cutaneous BCC and SCC
HISTORY An 86-year-old man on hemodialysis with multiple medical problems and on warfarin presented with two carcinomas of the nasal tip: BCC of the left nasal tip and SCC of the right nasal tip. The ulceration of the right SCC exposed the alar cartilage. Patient completed six (6) 5-fluorouracil injections over a 5-week period. Complete…
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