title: Importance of physical appearance in patients with skin cancer.
abstract: BACKGROUND
  Physical appearance influences nearly every aspect of human life-impacting how people are judged and subsequently treated by others.
  
  
  OBJECTIVE
  To summarize the literature that addresses the psychosocial impact of facial scarring, with a particular emphasis on scarring after skin cancer treatment.
  
  
  METHODS
  A comprehensive PubMed search was conducted to find articles related to scarring and appearance in the contexts of cutaneous oncology and surgical reconstruction. References from retrieved articles were also considered for review.
  
  
  RESULTS
  Scars, especially on the head and neck, change physical appearance and can negatively impact psychosocial functioning. Medical professionals may underestimate the importance of physical appearance for patients with skin cancer. Validated patient-reported outcome (PRO) tools may prove better than objective scar ratings to identify patients who may experience psychosocial impairment from scarring.
  
  
  CONCLUSIONS
  Scarring after skin cancer surgery can profoundly affect psychosocial functioning. Perioperative use of validated PRO tools can help to identify patients with scar concerns. Heightened awareness of patients' psychosocial status will allow practitioners to offer appropriate counseling or support.
authors: *Division of Dermatologic Surgery and Cutaneous Oncology, Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; †Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Philadelphia, Pennsylvania; Departments of ‡Psychiatry and §Surgery, University of Pennsylvania, Philadelphia, Pennsylvania; ‖School of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
authors: Joseph F
authors: JF
authors: Sobanko
authors: David B
authors: DB
authors: Sarwer
authors: Zinta
authors: Z
authors: Zvargulis
authors: Christopher J
authors: CJ
authors: Miller
mesh_terms: D001007:Anxiety / Q000209:etiology; D001828:Body Image; D002921:Cicatrix / Q000473:pathology / Q000523:psychology*; D006801:Humans; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000473:pathology / Q000523:psychology*; D011788:Quality of Life; D012878:Skin Neoplasms / Q000601:surgery*; D013315:Stress, Psychological / Q000209:etiology