By Ali Hendi, Juan Carlos Martinez

The occurrence of dermis melanoma has risen speedily in contemporary a long time, and sufferers frequently current at the start to practitioners in lots of assorted specialties. simply because pores and skin melanoma can differ in medical visual appeal, even dermatologists may well event trouble in attaining a medical analysis. For basic care physicians and health care professional extenders (physician assistants, nurses, and nurse practitioners), who've had little or no or no formal education in dermatology, the duty may be nonetheless extra daunting. during this atlas, the authors got down to offer a pragmatic source that would support enhance the 'visual vocabulary' of physicians and health professional extenders, aiding them determine lesions that are supposed to be biopsied. 1000s of top quality colour pictures are integrated to aid the reader within the activity of popularity and id. all the universal cutaneous malignancies are illustrated, with a couple of examples of every entity and of universal mimickers. additionally, biopsy suggestions and treatment plans are provided in step-by step element with using excessive solution scientific pictures, and capability issues of therapy are mentioned. This atlas is perfect for all companies who desire to sharpen their scientific acumen and achieve self assurance in deciding upon epidermis cancers.

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1 Variables crucial to proper management of patients with skin cancer. (Modified and reprinted from Mayo Clinic Proceedings. 2 NCCN guidelines: risk factors for recurrence of NMSC. (Modified and reprinted from Mayo Clinic Proceedings. With permission) Clinical risk factors Low risk High risk L – <20 mm M – <10 mm H – <6 mm Well defined Primary No L – ³20 mm M – ³10 mm H – ³6 mm Poorly defined Recurrent Yes No Yes No No Yes Yes Subtypeb Nodular, superficial Degree of differentiationa Well differentiated Infiltrative, micronodular, sclerotic, or morpheaform Moderately or poorly differentiated IV, V, or ³6 mm Location/size Borders Primary vs recurrent Immunosuppressed patient Tumor at site of prior XRT or chronic inflammatory process Rapidly growing tumora Neurologic symptoms: pain, paresthesia, paralysis Pathologic risk factors Depth: Clark’s level or I, II, III or <6 mm thicknessa Perineural or vascular No Yes involvement L areas at low risk for recurrence: trunk, extremities, M areas at middle risk for recurrence: cheeks, forehead, neck, scalp, H areas at high risk for recurrence: central face, eyelids, nose, chin, mandible, preauricular and postauricular skin/sulci, temple, ear, genitalia, hands, and feet a Applicable only to SCC b Applicable only to BCC carcinoma in situ.

38 Four buried mattress sutures in place. 4 Mohs Micrographic Surgery Mohs micrographic surgery is a specialized technique of excision and margin examination that provides the highest cure rates and maximum conservation of normal tissue. The cure rates associated with Mohs surgery for the treatment of BCC and SCC are well established and approach 99%. , eyelids, nose, ears, lips, genitalia, and shins). The method is performed in stages, whereby the surgeon initially anesthetizes and excises the clinically evident tumor or biopsy site.

Modified and reprinted from Mayo Clinic Proceedings. With permission) Clinical risk factors Low risk High risk L – <20 mm M – <10 mm H – <6 mm Well defined Primary No L – ³20 mm M – ³10 mm H – ³6 mm Poorly defined Recurrent Yes No Yes No No Yes Yes Subtypeb Nodular, superficial Degree of differentiationa Well differentiated Infiltrative, micronodular, sclerotic, or morpheaform Moderately or poorly differentiated IV, V, or ³6 mm Location/size Borders Primary vs recurrent Immunosuppressed patient Tumor at site of prior XRT or chronic inflammatory process Rapidly growing tumora Neurologic symptoms: pain, paresthesia, paralysis Pathologic risk factors Depth: Clark’s level or I, II, III or <6 mm thicknessa Perineural or vascular No Yes involvement L areas at low risk for recurrence: trunk, extremities, M areas at middle risk for recurrence: cheeks, forehead, neck, scalp, H areas at high risk for recurrence: central face, eyelids, nose, chin, mandible, preauricular and postauricular skin/sulci, temple, ear, genitalia, hands, and feet a Applicable only to SCC b Applicable only to BCC carcinoma in situ.

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