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Related Concept Videos

Skin Cancer01:30

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Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
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Epidermal stem cells (EpiSCs) are mainly located at the basal layer of the epidermis. These cells repair minor injuries of the skin and replace dead skin cells. However, EpiSCs’ cannot heal severe wounds such as major burns or those from diabetes or hereditary disorders. In such cases, culturing the epidermal stem cells from the patient is possible and has yielded successful treatment options, such as laboratory-grown skin grafts. These grafts are synthesized using a patient’s own...
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Management of Incompletely Excised Skin Tumors: Our Experience.

Bernard F Robertson1, James E T Wokes2, Haroon Siddiqui2

  • 1Canniesburn Plastic Surgery Unit, Glasgow Royal Infirmary, Glasgow, Scotland.

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Summary

Local surgical macroexcision is effective for incompletely excised skin cancers, achieving high success rates comparable to Mohs surgery. This approach offers a viable alternative for managing basal cell and squamous cell carcinomas in regions with limited Mohs surgery access.

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Area of Science:

  • Dermatology
  • Surgical Oncology
  • Oncology

Background:

  • Current guidelines suggest Mohs micrographic surgery for incompletely excised basal cell carcinomas (BCCs) and squamous cell carcinomas (SCCs).
  • Limited availability of Mohs surgery units necessitates alternative management strategies.
  • Multidisciplinary teams (MDTs) play a crucial role in managing complex skin cancer cases.

Purpose of the Study:

  • To evaluate the effectiveness and appropriateness of local surgical macroexcision for skin tumors with incomplete excision.
  • To compare outcomes of local surgical management with established Mohs surgery standards.

Main Methods:

  • Retrospective analysis of skin MDT records from July 2010 to July 2012.
  • Identification of patients with incompletely excised BCCs and SCCs.
  • Review of case notes and pathology reports to determine management and outcomes.

Main Results:

  • 73 incompletely excised skin cancers were identified; 54 underwent local surgical excision.
  • 94.4% of patients achieved complete tumor excision in a single procedure.
  • A low recurrence rate of 1.9% was observed after an average follow-up of 35 months.

Conclusions:

  • Local surgical management of incompletely excised skin tumors can achieve outcomes comparable to Mohs surgery.
  • This approach provides a feasible and effective alternative in regions with limited access to Mohs surgery.
  • Mohs surgery remains a valuable option for specific complex cases.