Clinical dermatology, cosmetic and surgical
Dr. Adrián Ogrodniczuk


Choice of surgical margens for the treatment of basal cell carcinoma


In the treatment of non-melanoma skin cancer, the main objective is the complete excision of the tumor, preserving the function with a suit- able cosmetic result. Because surgical treatment offers the highest cure rate and lower recurrence rates, is considered the first-line treatment; however, even today there are not standardized guidelines in the surgi- cal margin that ensure cure rate in 100% of the cases.

The squamous cell carcinoma is related to the amount of occupational exposure to solar radiation, while the basal cell carcinoma and melanoma are associated with the non-occupational exposure and recreational. Skin cancer is 50% of all types of cancer, the most frequent is the non-melanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma.

 In 2011, the American Cancer Society estimated that detected more than a million cases viously of non-melanoma skin cancers, basal cell carcinoma accounted for 80% to 90% the modalities of treatment against non-melanoma skin cancers are divided into surgical and non surgical. ; as surgical removal, electrosurgery, curettage and cryosurgery.

The non-surgical approaches that have been used are radiation therapy, imiquimod topical 5-fluorouracil (5-FU) and photodynamic therapy.
Thissen considered that Mohs micrographic surgery must be performed in carcinomas basocellular located in areas of risk, of great size, infiltrating or recidivantes.6 In the cases of basal cell carcinoma with smaller size or noninvasive, surgical removal is the treatment of choice, and in patients in whom surgery is contraindicated can be chosen other treatment options.

Dermatol Rev Mex 2015;59:294-302 

Daniel Alcalá-Pérez1 Diana Aline García-Arteaga2 Sonia Torres-González1 Juan Ramón Trejo-Acuña1 Armando Medina-Bojórquez3 Miguel Ángel Cardona-Hernández1