B. Gaji, T. Ro, M.

Ivkov Simi
Clinic for Dermatovenereology, Clinical Centre of Vojvodina

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

Surgical excisions of melanoma and non melanoma skin cancers are part of a routine daily tasks performed by a trained dermatologist in developed countries

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

Dermatology training curiculum in Serbia recognizes aquiring skills in surgical excisions of skin cancers as essential as from 2013/2014 academic year
First visite diagnosis of BCC was made

Excision - M plasty Sutures

14 days after surgery

At a 6 monthly follow up

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

Dermatologists in Serbia are aware of the benefits of performing excisional skin biopsies in various dermatoses where the diagnosis has to be confirmed by histology report, or the diagnosis is obscure...

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

NON MELANOMA SKIN CANCERS WHY A DERMATOLOGIST?

SKIN CANCERS - WHY A DERMATOLOGIST?

Rhynophyma? BCC & Rhynophyma

A long term rosacea patient reffered for electrosurgical treatment of rhynophyma

SKIN CANCERS - WHY A DERMATOLOGIST?

SUPERFICIAL BASAL CELL SKIN CANCER IS ONE REASON...

Obvious...

Psoriasis?

Eczema?

Scar?

SKIN CANCERS - WHY A DERMATOLOGIST?

Patient reffered for lesion on left forearm On examination congenital naevus PLUS...... On full skin examination Multiple basal cell skin cancers on trunck and face

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

Since Jan 2010 at the Daily surgery unit of a Clinical

Centre of Vojvodina dermatologists are performing excisional skin biopsies and therapeutic excisions of BCC s and SCC s.
During the three year interval (2010 - 2012) a total of 399 basal cell skin cancers and 30 squamous cell skin cancers were excised.

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

- BCC : SCC = 13 : 1 ? more BCCs reffered to a dermatologists ? NEW discovered at follow up visits? ? more SCCs reffered to other specialists, oncology council - Histology correlates with clinical diagnosis in more than 95%
POVRATNE BCC uputne, BCC

uputne povratne

POVRATNE SCC uputne,SCC,

povratne
uputne

BCC

SCC

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

HISTOLOGY REPORT OF EXCISED CLINICALY DIAGNOSED BCC
1 2 3 2% 1% 1%

Premalignant lesions Other malignant tumours

benign lesions

4 96%

corresponds to the clinical diagnosis of NMSC

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

Sex ratio

YOUNGEST 28 yrs OLDEST 88 yrs AVERAGE 66,7 yrs

FEMALE

MALE

49%

51%

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

Upper extremities 5%

DISTRIBUTION
14%

Lower extremities 2%

Body

13%

Head and neck

66%

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

The nuber of BCCs by other specialist (ENT, plastic

and reconstructive surgeons, maxillofacial surgeons ) INCREASED

The number of BCCs treated conservatively (5 %

imiquimod cream, 5 fluorouracil cream) also INCREASED

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

Dermatologists are Specialist for plastic and

better at diagnosig NMSC

Dermatologists are

better at treating NMSC both conservatively and surgicaly

reconstructive surgery, ENT specialists, maxilofacial surgeons are better at recognizing BCCs and benign skin tumours that do not worrent surgical treatment

SURGICAL EXCISIONS OF SKIN CANCERS IN DERMATOLOGY SETTINGS IN SERBIA

WHAT IS NEXT?
OR WHAT IS

YEAR 2012. AD, CENTURY XXI, A 53 YO LADY, NOVI SAD, SERBIA

FIRST?
PREVENTION