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Skin cancer is the most common cancer, fortunately the majority of these cancers are mild and easily treated. The two most common types of skin cancer are basal cell carcinoma and squamous cell carcinoma. Less common, but much more dangerous, are malignant melanomas.
Basal Cell Carcinoma and Squamous Cell Carcinoma
These are “garden variety” skin cancers related to sun exposure. Treatment involves excision with clear margins. The wound is closed in a fashion to minimize resulting deformities.
In areas of the body where minimizing the amount of tissue removed (eyelid, nose…) or when the margins of the tumor are not easily defined something called Mohs excision can be useful. Mohs surgery is a staged excision performed by a dermatologist. After each stage the tissue is examined under the microscope for any residual tumor. This is repeated until all of the tumor is excised.
Dr. Yates considers these types of repairs particularly challenging and rewarding. It is easy to get a wound closed. The trick is restoring form and function while hiding the scar in a conspicuous location.
Basic techniques used to reconstruct the defect include skin grafting, local tissue rearrangement and distant tissue repair.
These are the dangerous types of skin cancer that have a high risk of metastasis (spread) through the body. The risk of spread is directly related to the depth of the wound. The depth of the wound is related to the duration the tumor has been present. For this reason, if you have a skin lesion which is changing, see your doctor. Suspicious signs for malignant melanoma include irregular margins, dark brown/ black, and irregular pigmentation.
Treatment of melanoma involves wide excision with coverage of the wound with a flap or graft as indicated. Occasionally lymph node biopsy or chemotherapy are indicated.