Abstract
High-risk nonmelanoma skin cancers of the head and neck may be identified through
a variety of tumor risk factors, including location on the lips or ears, size > 2 cm,
recurrence, patient immunocompromised status, poor tumor differentiation, > 6 mm thickness,
Clark level V depth of invasion, and presence of perineural spread. Surgical excision
is the mainstay of treatment, with Mohs' micrographic surgery typically preferred
to standard surgical excision. When reconstructing these defects, ensuring negative
margins is of utmost importance and delaying reconstruction until confirmation of
margins is recommended. Attention to the impact of immunosuppression and adjunct radiation
therapy on wound healing is important for an optimal cosmetic outcome. As with all
high-risk cancer patients, close follow-up and surveillance of these patients is imperative.
Keywords
nonmelanoma skin cancer - squamous cell carcinoma - basal cell carcinoma - high risk
- reconstruction
