Chapter 24 : Management of Basal and Squamous Cell Carcinoma

The clinical presentation, differential diagnosis, and etiologic factors for basal cell carcinoma and squamous cell carcinoma were detailed in Chapter 19. This chapter defines the treatment modalities that are effective in extirpating cutaneous basal cell and squamous cell carcinomas, including electrosurgery, excisional surgery, cryosurgery, irradiation, and Mohs surgery. The last technique, also known as microscopically controlled excision, will be detailed, including its historical evolution, the technique itself, indications for its use, and a brief discussion of options for reconstruction of defects. Once the modalities have been discussed, a section dealing with the choice of the appropriate modality will follow. For the most part, basal cell and squamous cell carcinoma will be dealt with in the same fashion, since the treatment modalities are similar for each. Fig. 24-1 outlines a schematic approach to basal cell carcinoma.