Patient Case Studies
Vismodegib – A Breakthrough in Basal Cell Carcinoma Treatment
Vismodegib, a Hedgehog Pathway Inhibitor, has been recently shown to be highly effective for advanced basal cell carcinoma in Phase II clinical studies. Discovery of the Hedgehog Signaling Pathway is enlightening in how three unrelated basic science research paths can meet at crossroads of cancer treatment breakthrough. First, there were sheep in Idaho in 1957…
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Peri-Auricular Neoplasm – Deception in Waiting
Peri-auricular subcutaneous lesions can be deceptive. These neoplasms have a higher risk of being non-dermal-related tumors than neoplasms of other areas of the face. Attempts at excision without consideration of a differential diagnosis can often lead to tumor compromise. Over the last several months, SCARS Center has treated several tumors previously excised partially by other…
Read MoreLong Term Radiation Consequences
This month we presented a case of radiation dermatitis some 20+ years following radiation treatment of skin carcinoma. This case had the classic presentation of a dry ulcer surrounded by atrophic hypopigmented skin. Clearly, incisional biopsy is recommended to differentiate this from a delayed radiation-induced malignancy. This delayed presentation of radiation dermatitis is unusual and…
Read MoreRadiation Therapy of Skin Cancer: Dosing and Complications
Although, radiation of ear carcinomas can pose a risk of chondritis and poor healing, that risk can be virtually eliminated with lower dose fractions (radiation dose per treatment) spread over a longer course. Total dose requirement for skin cancer treatment ranges from 3500 cGy to 6000 cGy depending on the size and depth of the…
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Acceptance of Residual Melanoma-In-Situ: Avoiding Cosmetic and Functional Deformation
Acceptance of residual melanoma-in-situ (lentigo maligna) after an excision can avoid cosmetic and functional deformation. Is the residual risk of recurrence and transformation into invasive melanoma low enough to warrant observation? Melanoma-in-situ (MIS) is a high risk lesion due to three primary reasons. The first is that a partially biopsied melanocytic lesion with a diagnosis…
Read MoreMelanoma-in-situ of the Chin
A middle-age man with previous melanoma-in-situ of the back presents with new chin lesion biopsied as melanoma-in-situ on a deep shave biopsy. Subsequent surgical excision with 2 mm margins revealed no evidence of residual melanoma. Observation was chosen as the course of management. Should additional wider margin resection be performed? Melanoma-in-situ (MIS) is a high…
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