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It has been postulated that elliptical cutaneous excisions must possess a length-to-width ratio of 3:4 and a vertex angle of 30 ̊ or less in order to be closed primarily without creating a “dog ear”. These dimensions became axiomatic in cutaneous surgery and have been taught in the apprenticeship model for years. A study examined the validity of that paradigm. Continue reading “[3 min read] Surgical ellipse: Are the length-to-width ratio of 3:4 and a vertex angle of 30 ̊ correct?”
In this webinar, Dr Tony Dicker discussed performing skin cancer surgery in the difficult area below the knee with practical hints and tips for best results. Continue reading “[WEBINAR] Hints for skin cancer surgery below the knee”
In this month’s skin cancer update video, Professor Giuseppe Argenziano continues his two-part discussion from last month about the role of Imiquimod in the treatment of lentigo maligna. Using real patient case examples, Giuseppe discusses Imiquimod in an adjuvant setting, including how it can be applied in a clinical setting after surgery has been performed. Continue reading “[4 min watch] Skin Cancer Update with Prof Giuseppe Argenziano [June 2019]”
This month, we consider what to do when a partial biopsy of a suspected melanoma is performed.
The general advice is that if a punch or shave (partial) biopsy has been done, then an excision biopsy should be done before a formal wide-local excision. This is so that complete staging (of Breslow thickness) can be assured before the excision is done. Continue reading “[3 min read] What to do when a partial biopsy of a suspected melanoma is performed”
What method do patients prefer for surgical treatment of facial melanoma, and what causes patients to value the importance of surgery? Continue reading “[4 min read] What surgery do patients prefer for facial melanoma and what influences their choice?”
25 – 28 July 2018 | Brisbane
The 10th Skin Cancer Summit & Masterclasses saw international thought leaders in skin cancer medicine converge in Brisbane to collaborate with GPs from across Australia. The 2018 program once again covered a broad range of topics relevant to doctors working in primary care skin cancer medicine. The Masterclasses focused on core day-to-day material, as a way to reinforce and extend knowledge. The two-day Summit opened up new areas of study, enquiry and interest.
Dermoscopy Masterclass: 25 July 2018
Dr Lallas used the concept of false positive and false negative diagnoses to reinforce our diagnostic accuracy. Clearly, as morphology overlaps the distinction between what is a cancer, and what is not, can provide confusion.
This broad concept was beautifully extended by Prof Marghoob through his presentation on difficult to diagnose melanomas. As we all know, the easy ones are easy. It is the hard-to-diagnose that we risk missing!
The session then moved into important body sites – the face and acral areas, which are important because the morphology of lesions on these sites is different from morphology on other sites. If we don’t understand this and know how the appearances differ, then we can’t accurately recognise cancers.
Our presenters then extended these important concepts to difficult to diagnose non-melanoma skin cancers, as it is not just melanomas that can be tricky. And, as always, we finished with a series of interactive cases.
Surgery Masterclass: 26 July 2018
The second Masterclass covered surgery of the ear. The ear, of course, is a common site for skin cancer because it is so exposed to solar damage. Ear surgery is important because cosmetic results are very visible to the patient and others. So, it is essential to get the surgery right, cure the cancer, and repair the defect as sympathetically as possible.
Dr Con Pappas and Dr Tony Azzi provided a comprehensive overview of how to prepare for and conduct surgery of the ear, across almost all imaginable lesions.
Summit: 27-28 July 2018
The Summit program is deliberately designed to be a mix of very practical, everyday material that supports our daily practice.
This year, key examples of these sessions were those on ‘effectiveness of dermoscopy’, ‘why we miss melanoma’, and ‘radiation oncology’. We also ran sessions that we hope will keep you and your patients safe, including ‘what interests the watchdog’ and ‘monitoring tips and traps’.
We deliberately moved into the future and sought to explore and speculate on what might be. It is clear that artificial intelligence is already with us, and yet most of us don’t really see what is happening and what might be coming. As educated and interested professionals, it is worth being aware of these trends.
We also like to keep you across what is happening outside clinical practice, in areas that are relevant to running your business. So, our sessions on how to run a successful business, and how others organise their own practices, are always very popular.
The Skin Cancer Summit closed with a Gala Dinner at the Queensland Cricketers’ Club. Hosted by the Skin Cancer Institute, the inaugural ‘White Out Skin Cancer’ Gala Dinner donated all proceeds to QIMR Berghofer. The delegates’ generosity and support will make a difference to many lives as we take a step closer to our vision of a world where nobody dies from skin cancer.
Do you have many patients with anxiety? This month’s article deals with a – perhaps – uncommon, but not unimportant issue: managing patient anxiety while undergoing skin cancer excision. Continue reading “Managing patient anxiety while undergoing skin cancer excision”
The 2008 evidence-based clinical practice guidelines for the management of melanoma are currently being revised and updated in a staged process by a multidisciplinary working party established by Cancer Council Australia. The guidelines for definitive excision margins for primary melanomas have been revised as part of this process. Continue reading “Updated Practice Guidelines for Melanoma Management”
This week we have another interesting case. What is your assessment of the clinical and dermoscopic pictures, and what would you do next? This lesion was on the upper back and the patient was unaware of it.
Complete removal of individual dysplastic nevi is often achieved by a second surgical procedure after the initial biopsy. The choice to perform the second procedure is strongly influenced by the histopathologic margins of the initial biopsy specimen.
A study recently published in the Journal of the American Academy of Dermatology evaluated the clinical and histopathologic outcomes of total biopsy of dysplastic nevi using a pre-determined margin of normal skin. Continue reading “Biopsy Margin for Total Removal of Dysplastic Nevi”