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Merkel cell carcinoma (MCC) is often treated with surgery and postoperative radiation therapy (PORT). The optimal time to initiate PORT (Time-to-PORT [ttPORT]) is unknown. We assessed if delays in ttPORT were associated with inferior outcomes. Competing risk regression was used to evaluate associations between ttPORT and locoregional recurrence (LRR) for patients with stage I/II MCC in a prospective registry and adjust for covariates. Distant metastasis and death were competing risks. The cohort included 124 patients with median ttPORT of 41 days (range: 8-125 days). Median follow-up was 55 months. 17 (14%) patients experienced a LRR, 14 (82%) of which arose outside the radiation field. LRR at 5 years was increased for ttPORT >8 weeks vs ≤ 8 weeks, 28.0% vs 9.2%, P =.006. There was an increase in the cumulative incidence of MCC-specific death with increasing ttPORT (HR = 1.14 per 1-week increase, P =.016). The relatively low number of LRRs limited the extent of our multivariable analyses. Delay of PORT was associated with increased LRR, usually beyond the radiation field. This is consistent with the tendency of MCC to spread quickly via lymphatics. Initiation of PORT within 8 weeks was associated with improved locoregional control and MCC-specific survival. [ABSTRACT FROM AUTHOR]

Epidemiology studies on twins have demonstrated that about 58% of melanoma incidence is attributable to genetic variation.[9] Although 10% of individuals with melanoma will have an affected first degree relative,[10] only 10% of those cases will have a strong family history (ie, three or more cases related in the first or second degree).[[11]] Therefore, familial melanoma accounts for a relatively small portion of melanoma heritability. An Australian randomised control trial is currently underway to evaluate the clinical impact and cost effectiveness of using melanoma surveillance photography for those at high risk of melanoma, from a health system perspective, run through melanoma and skin cancer trials (ClinicalTrials.gov, NCT04385732). Keywords: Melanoma; Dermatologic surgical procedures; Skin neoplasms; Early detection of cancer; Dermatology; Surveillance EN Melanoma Dermatologic surgical procedures Skin neoplasms Early detection of cancer Dermatology Surveillance 426 431 6 05/17/23 20230515 NES 230515 Summary Australia has one of the highest rates of cutaneous melanoma in the world. Neoadjuvant therapy represents a new approach to melanoma management and involves administering systemic therapy for a short duration before surgery in patients with resectable stage III disease. [Extracted from the article]

Development of post-irradiation skin toxicity depends on dose, fractionation, technique, and type of radiotherapy, as well as concurrent treatment and comorbid conditions affecting the skin. Keywords: Dermatologic surgical procedures; Radiotherapy; Skin neoplasms EN Dermatologic surgical procedures Radiotherapy Skin neoplasms 12 14 3 06/30/23 20230701 NES 230701 Clinical record A 62-year-old man with a more than 30-year history of actinic keratoses and keratinocyte carcinomas presented for ongoing management. Post-irradiation skin toxicity limits management options for subsequent skin cancer in the previously irradiated field and increases the risk of surgical complications. [Extracted from the article]

With the failure of all these treatments to provide long term control of his skin cancers, now systemic therapy warrants consideration. The patient had required hundreds of treatments of many types for individual lesions before VMAT and was moving into wider field treatments as the disease became more aggressive. REFERENCES 1 Morton SK, Ozluer S, Muir J. Field cancerisation and radiotherapy: a case of treatment complications. [Extracted from the article]

Skin neoplasms, Radiotherapy, Dermatologic surgical procedures Irradiation fibrosis required referral to a plastic surgeon for complex skin closures. Keywords: Skin neoplasms; Radiotherapy; Dermatologic surgical procedures EN Skin neoplasms Radiotherapy Dermatologic surgical procedures 335 335 1 10/04/23 20231001 NES 231001 Open access Open access publishing facilitated by The University of Queensland, as part of the Wiley - The University of Queensland agreement via the Council of Australian University Librarians. [Extracted from the article]

To maximise the diagnostic yield of a skin biopsy, an understanding of the different types of biopsy, their indications and limitations is vital (Box 1 and Box 2). Once the area is anaesthetised, the punch biopsy should be performed by placing the biopsy blade perpendicular to the skin, then rotating it clockwise and counterclockwise until the superficial subcutis is reached (Supporting Information, video 1). Skin biopsy: biopsy issues in specific diseases. [Extracted from the article]