DermHelpCentral

In a Perfect World, Rosacea Remains a Problem

There was a fine article about rosacea in the Thursday, April 20, NY Times.  Every dermatologist sees a few cases a week.  This is a fine article for one's patients to refer to.

You may access the article at: Permalink

Skin Cancer Grand Rounds

On April 10 - 11, I gave Grand Rounds on Skin Cancer at the Thayer Hospital in Waterville, Maine and the MId-Maine Medical Center in Augusta, Maine.  The handout is attached here:  Download grand_rounds_april_web.pdf  

Skin Cancer Primer

This posting is intended as a guide for physicians and patients who may want a bit of education about skin cancer.  One caveat:
"A little learning is a dangerous thing; drink deep, or taste not the Pierian spring: there shallow draughts intoxicate the brain, and drinking largely sobers us again."  Alexancer Pope, Essay on Criticism.

The common skin cancers are: basal cell carcinoma (BCC), melanoma (MM) and squamous cell carcinoma (SCC)
You will also want to know about actinic (solar) keratoses, keratoacanthoma (KA) and dysplastic nevi.  This page will address all of these entities but may take a month or two to complete.

Skin Cancers are commonly encountered.

yet the death rate from nonmelanoma (NMSC) skin cancer is very low. Note: these are deaths per 100,000 people.

Actinic (Solar) Keratoses (AK)

AK is a UV light–induced lesion that is common in light-complected individuals.  Few if any progress to SCC, but some lesions that look like AK can actually be SCC-in situ. These are larger that the typical ones and usually hypertrophic.

A group of dermatologists and pathologists are trying to say that AKs are really very early skin cancers.  This creates a lot of anxiety for patients and increased income for patients.  Robin Marks of Australia has done the most research on the subject and wrote a recent editorial in the British J. of Dermatology. "Who benefits from calling AK SCC?" Download ak_marks.pdf

Hypertrophic AK (lesions like this should  be biopsied since they could also be in-situ SCC)
The majority of AKs can be observed

Here's a chapter on AKs from eMedicine 

Basal Cell Carcinoma (BCC)

These are common lesions that all physicians see with regularity.  The variants that you need to be aware of are nodular, superficial and morphea (sclerosing or scarring)  Please go to BCC/eMedicine for more information.