• Dermatol Surg · May 2015

    Practice Guideline

    Consensus for nonmelanoma skin cancer treatment: basal cell carcinoma, including a cost analysis of treatment methods.

    • Arielle N B Kauvar, Terrence Cronin, Randall Roenigk, George Hruza, Richard Bennett, and American Society for Dermatologic Surgery.
    • *New York Laser & Skin Care, New York, New York; †Department of Dermatology, New York University School of Medicine, New York, New York; ‡Department of Dermatology, University of Miami, Miami, Florida; §Department of Dermatology, Mayo Clinic, Rochester, Minnesota; ‖Laser & Dermatologic Surgery Center, Chesterfield, Missouri; ¶Department of Dermatology, St. Louis University, St. Louis, Missouri; #Department of Dermatology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California; **Department of Dermatology, Keck School of Medicine, University of Southern California, Los Angeles, California.
    • Dermatol Surg. 2015 May 1; 41 (5): 550-71.

    BackgroundBasal cell carcinoma (BCC) is the most common cancer in the US population affecting approximately 2.8 million people per year. Basal cell carcinomas are usually slow-growing and rarely metastasize, but they do cause localized tissue destruction, compromised function, and cosmetic disfigurement.ObjectiveTo provide clinicians with guidelines for the management of BCC based on evidence from a comprehensive literature review, and consensus among the authors.Materials And MethodsAn extensive review of the medical literature was conducted to evaluate the optimal treatment methods for cutaneous BCC, taking into consideration cure rates, recurrence rates, aesthetic and functional outcomes, and cost-effectiveness of the procedures.ResultsSurgical approaches provide the best outcomes for BCCs. Mohs micrographic surgery provides the highest cure rates while maximizing tissue preservation, maintenance of function, and cosmesis.ConclusionMohs micrographic surgery is an efficient and cost-effective procedure and remains the treatment of choice for high-risk BCCs and for those in cosmetically sensitive locations. Nonsurgical modalities may be used for low-risk BCCs when surgery is contraindicated or impractical, but the cure rates are lower.

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