Faculty Bibliography

The number of skin cancers continues to rise with well over one million cases of skin cancer expected in the United States this year. Optimal management depends on early detection and treatment. The consequences of skin cancer may be particularly devastating in organ transplant recipients. In this article, management of squamous cell carcinoma in the organ transplant recipient is discussed

Surgical excision with clear margins remains the treatment of choice for melanoma. Under appropriate conditions MMS may offer a means of achieving clear margins while sparing normal tissue. This requires a Mohs' surgeon expert in interpretation of melanocytic lesions and excellent technical support. As the popularity of special histologic stains continues to grow these may offer and additional means to increase sensitivity and specificity in the detection of melanoma

BACKGROUND: Immediate reconstruction after removal of skin cancer by Mohs micrographic surgery (MMS) may not be feasible in patients unwilling or unable to undergo an extensive procedure. Human cadaveric allograft (HCA) may offer a useful alternative to granulation. OBJECTIVE: To examine the usefulness of HCA in resurfacing nasal defects after extirpation of basal cell carcinoma (BCC) by MMS. METHODS: Case histories of seven patients treated with HCA were reviewed with respect to primary skin cancer histology, defect size, medical status, healing time, and cosmesis. RESULTS: Five of seven tumors were infiltrative BCCs. Defects ranged from 2.7 to 20 cm2. Average healing times for wounds with and without exposed cartilage were 42 and 35 days, respectively. There were no wound infections. Hypergranulation tissue was noted in three patients and had no effect on cosmesis, which was adequate in five patients and poor in two patients. CONCLUSION: HCA may be a useful alternative to granulation following MMS for treatment of skin cancers involving the nose

Lentigo maligna (LM) is an indolent form of melanoma in situ with the potential to progress to invasive melanoma. Early detection and adequate treatment prior to development to invasive melanoma are essential. Definitive excision with negative margins is currently the treatment of choice for LM. Conventional excision, Mohs micrographic surgical excision, and nonexcisional methods of treatment of LM will be discussed

Botulinum A exotoxin, derived from the gram-positive anaerobe Clostridium botulinum, has proven to be safe and effective in the temporary treatment of facial rhytides. In order to obtain reproducible results and avoid complications, it is necessary to understand the relevant physiology and anatomic relationships. Technical considerations including injection technique, dilution, storage, and potential complications will be discussed