MOC-PSSM CME article: Nonmelanoma facial skin malignancy.
OBJECTIVE
After studying this article, the participant should be able to: 1. Identify the environmental and genetic risk factors in developing nonmelanoma facial skin malignancy. 2. Understand the proper evaluation of a patient presenting with nonmelanoma facial skin malignancy. 3. Outline the various treatment options available for patients with nonmelanoma facial skin malignancy and understand the specific technique of Mohs' micrographic surgery versus surgical excision with frozen section control. 4. Describe the various options for reconstruction and the associated anesthetic requirements.


BACKGROUND
The incidence of nonmelanoma facial skin malignancy is rising dramatically. Physicians should be well versed on the appropriate methodology required to both evaluate and treat these patients.


METHODS
A literature review was performed regarding the evaluation and various management options for patients with nonmelanoma facial skin malignancy. Specific attention was paid to the Mohs' technique versus surgical excision with frozen section control for treatment of these patients.


RESULTS
An algorithm is presented regarding the appropriate assessment and treatment of patients with nonmelanoma facial skin malignancy. Comparison of the Mohs' technique with frozen section control showed potentially similar disease-free outcomes. However, the lack of adequate scientific studies for surgical excision with frozen section control was identified.


CONCLUSIONS
Various treatment algorithms exist for nonmelanoma facial skin malignancy. Consideration must be given by the physician to patient comorbidities, anesthesia requirements, appropriate monitoring, and cost of excision.
Zbar
Ross I S
RIS
Montclair, N.J.; and Iowa City, Iowa From the Wound Care Center, Mountainside Hospital, and the Departments of Surgery and Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics.
Canady
John W
JW
D000758:Anesthesia; D002277:Carcinoma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D002280:Basal Cell Carcinoma / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005145:Face / Q000473:pathology / Q000601:surgery; D005629:Frozen Sections; D006801:Humans; D015580:Mohs Surgery / Q000009:adverse effects*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D012878:Skin Neoplasms / Q000175:diagnosis / Q000209:etiology / Q000601:surgery* / Q000628:therapy; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing