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Facial Plast Surg 2020; 36(02): 141-147
DOI: 10.1055/s-0040-1709132
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

High-Risk Nonmelanoma Skin Cancers: Identification, Management, and Reconstruction

Authors

  • Emily S. Misch

    1   Department of Otolaryngology—Head and Neck Surgery, University of Colorado, Aurora, Colorado

  • Adam M. Terella

    1   Department of Otolaryngology—Head and Neck Surgery, University of Colorado, Aurora, Colorado
Further Information

Publication History

Publication Date:
15 May 2020 (online)

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Abstract

High-risk nonmelanoma skin cancers of the head and neck may be identified through a variety of tumor risk factors, including location on the lips or ears, size > 2 cm, recurrence, patient immunocompromised status, poor tumor differentiation, > 6 mm thickness, Clark level V depth of invasion, and presence of perineural spread. Surgical excision is the mainstay of treatment, with Mohs' micrographic surgery typically preferred to standard surgical excision. When reconstructing these defects, ensuring negative margins is of utmost importance and delaying reconstruction until confirmation of margins is recommended. Attention to the impact of immunosuppression and adjunct radiation therapy on wound healing is important for an optimal cosmetic outcome. As with all high-risk cancer patients, close follow-up and surveillance of these patients is imperative.

Keywords

nonmelanoma skin cancer - squamous cell carcinoma - basal cell carcinoma - high risk - reconstruction