Preoperative margin detection by digital dermoscopy in the traditional surgical excision of cutaneous squamous cell carcinomas
Department of Dermatologic Surgery, Centro Ortopedico di Quadrante Hospital , Omegna (VB) , Italy.Journal of Dermatological Treatment (Impact Factor: 1.67). 03/2012; 24(3). DOI: 10.3109/09546634.2012.672711
Abstract Background: The incomplete excision rate is a useful clinical and performance indicator, as it correlates with the treatment, the recurrence rate, the patient's morbidity and mortality. Methods of preoperative assessment of tumoral margins are therefore of paramount importance. Dermoscopy is a simple, non-invasive method, and can also be used for the diagnosis of epithelial tumors. Objective: The aim of the study is to assess the preoperative evaluation of margins with digital dermoscopy, and compare it with clinical evaluation; to ameliorate the surgical performance. Patients and methods: Ninety-four patients with histologically confirmed squamous cell carcinomas were initially selected for traditional surgical excision. Subsequently, the margin of excision was determined by both clinical (group A, 46 patients) and dermoscopy evaluation (group B, 48 patients). Results: In group A, margin involvement was observed in eight (17%) patients. Positive margins were seen in three (6%) patients of group B. Conclusions: Preoperative digital dermoscopy is a better method for detecting tumoral margins than clinical evaluation, and is an effective, simple, non-invasive method for the presurgical evaluation of margins.
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ABSTRACT: This article focuses on the surgical treatment of nonmelanoma skin cancers of the head and neck. The risk factors of nonmelanoma skin cancers for recurrence and metastases that are important for choosing the best treatment option are summarized. Surgical treatment options including surgical excision with standard margins, frozen section, staged surgery, and Mohs micrographic surgery are described. Indications, techniques, outcomes, and advantages and disadvantages of each approach are reviewed. Finally, management of incomplete excisions is discussed.Facial plastic surgery clinics of North America 11/2012; 20(4):455–471. DOI:10.1016/j.fsc.2012.08.001 · 0.72 Impact Factor
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