What factors should you consider in treating NMSC?

The method of destruction depends upon the type and subtype of malignancy, degree of invasion, location, health of the patient, potential for recurrence or metastasis, and availability of various methods (Table 44-2).

Neville J, Welch E, Leffell D: Management of nonmelanoma skin cancer in 2007, Nat Clin Pract Oncol 4:462–469, 2007.

 

Table 44-2. Management of Cutaneous Premalignancies and Malignancies
	LESION		TREATMENT
	Actinic keratosis		Cryosurgery Curettage Fluorouracil, topical Chemical peel Dermabrasion Imiquimod Photodynamic therapy
	Actinic cheilitis		Cryosurgery Electrosurgery Chemical peel Laser ablation Lip shave and advancement Imiquimod
	Basal cell carcinoma (BCC)
	Superficial spreading		Cryosurgery Curettage ± electrosurgery Laser ablation Imiquimod Photodynamic therapy
	Nodular BCC		Cryosurgery Curettage and electrosurgery Excision Radiation therapy Photodynamic therapy Mohs surgery
	Morpheaform, aggressive BCC, or recurrent BCC		Excision Mohs surgery
	Nonresectable BCC		Cryosurgery Radiation therapy Chemotherapy
	Keratoacanthoma		Deep shave plus curettage Curettage plus electrosurgery Intralesional 5-fluorouracil Cryosurgery Excision Mohs surgery
	SCC in situ (Bowen’s disease)		Curettage ± electrosurgery Fluorouracil, topical Imiquimod Cryosurgery Laser Excision Photodynamic therapy
	Squamous cell carcinoma (SCC)
	Small, nonaggressive		Curettage plus electrosurgery Cryosurgery Excision
	Large or aggressive		Excision Mohs surgery Radiation therapy Lymph node dissection
	Nonresectable SCC		Radiation Chemotherapy