Evidence-based medicine: facial skin malignancy

Area of Science:

• Dermatology
• Surgical Oncology
• Plastic Surgery

Background:

• The head and neck are the most common sites for skin lesions due to cumulative sun and carcinogen exposure.
• Skin lesion excision is a frequent procedure for plastic surgeons.
• Early diagnosis and treatment are crucial for preventing metastasis.

Purpose of the Study:

• To identify common precancerous and malignant cutaneous growths of the head and neck.
• To recommend surgical treatment, including margins, based on consensus guidelines.
• To counsel patients on recurrence, follow-up, and morbidity.

Main Methods:

• A systematic review of relevant guidelines and clinically rigorous studies was performed.
• Treatment recommendations were summarized for various skin lesions.
• Focus on actinic keratosis, Bowen disease, basal cell carcinoma, squamous cell carcinoma, malignant melanoma, and Merkel cell carcinoma.

Main Results:

• Guidelines for surgical margins and adjuvant therapy were reviewed.
• Information on expected recurrence, follow-up, and morbidity was compiled.
• Summarized treatment recommendations for common head and neck skin cancers.

Conclusions:

• Timely diagnosis and appropriate surgical margins are critical for preventing spread and metastasis.
• Adjuvant therapy may be necessary to prevent recurrence and optimize survival.
• Ongoing outcome studies continuously refine treatment recommendations for skin cancers.