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Comment & Response
December 9/23, 2013

Treatment of Nonmelanoma Skin Cancer

Author Affiliations
  • 1Division of Dermatologic Surgery, University of Rochester Medical Center, Rochester, New York
JAMA Intern Med. 2013;173(22):2095. doi:10.1001/jamainternmed.2013.10414

To the Editor This letter is in response to the recent article by Linos et al.1 As a dermatologic surgeon whose practice is limited to the treatment of nonmelanoma skin cancer (NMSC), a question comes up almost daily from care providers of elderly patients: “My mom is 87, do we really need to treat this?” As the authors mention, although most NMSCs are not life threatening, those of us who manage these diseases are witness to the deep destruction and profound impact on quality of life that they can cause if left untreated. Suspected lesions should always be biopsied because more serious diagnoses such as melanoma or Merkel cell carcinoma are real possibilities, and patients, no matter how old, should be made aware of these conditions. The study does an excellent job of solidifying the safety and efficacy of existing treatments for NMSC. With respect to complications, only 15% of patients responded. These “complications” included minor, temporary symptoms such as numbness and itching, and were not evaluated by the treating physician. There is no reference to complications such as bleeding or infection, presumably because the incidence of these events was low as has been demonstrated previously.2

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