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Resumen Antecedentes y objetivo El carcinoma de celulas de Merkel es un tipo de cancer de piel infrecuente y agresivo. Hay una gran variacion en su manejo y las diferentes guias extranjeras que existen cubren parcialmente los problemas identificados como principales. El objetivo de la presente guia es servir de referencia a los dermatologos espanoles para mejorar aspectos controvertidos del diagnostico, estadificacion y tratamiento del carcinoma de celulas de Merkel. Materiales y metodos Se empleo el metodo ADAPTE: se escogio a miembros del Grupo Espanol de Dermato-Oncologia y Cirugia (GEDOC) con experiencia en el tratamiento de estos tumores y con interes en participar en la elaboracion de la guia. Tras resumir el proceso de atencion y elaborar las preguntas clinicas relevantes, se hizo una busqueda de guias, que se seleccionaron segun su puntuacion mediante el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE II). Tras la busqueda de las respuestas en dichas guias, se elaboraron posteriormente las recomendaciones. Por ultimo, se sometio la guia a revision externa. Resultados Las guias con mejor puntuacion fueron las de National Comprehensive Cancer Network, la European consensus-based interdisciplinary guideline, Alberta Healthservices Clinical practice guideline, American Cancer Society y Cutaneous Oncology Group of the French Society of Dermatology. Se obtuvieron en total 9 preguntas clinicas, contestadas a partir de estas guias. Conclusiones Esta guia responde a preguntas habituales en la practica clinica diaria y sirve a los dermatologos como referencia en la toma de decisiones, siempre teniendo presentes los recursos y preferencias del paciente.

Background and objective Merkel cell carcinoma is a rare, aggressive skin cancer that is managed in a great variety of ways. However, international clinical practice guidelines give only partial coverage to issues considered major problems.The recommendations presented here aim to provide Spanish dermatologists with a guide to improving disputed aspects of diagnosis, staging, and treatment of localized Merkel cell carcinomas. Material and methods The ADAPTE process was used. Members of the Spanish Group of Oncologic Dermatology and Surgery (GEDOC) with experience in treating Merkel cell carcinoma and interest in drafting these guidelines were selected. The group described the care process and listed the most important clinical questions. They then searched for guidelines and assessed them with the AGREE II (Appraisal of Guidelines for Research and Evaluation) tool. After consulting the guidelines for answers to their clinical questions, the group drafted the present statement and sent it for external review. Results The guidelines that scored highest in the AGREE II assessment step were the consensus-based interdisciplinary guideline of the European Association of Dermato-Oncology and the European Organization of Research and Treatment of Cancer, and those of the Comprehensive Cancer Network, the Alberta Health Services in Canada, the American Cancer Society, and the Cutaneous Oncology Group of the French Society of Dermatology. A total of 9 clinical questions were answered based on these guidelines. Conclusions The guidelines presented here answer clinical questions that arise in routine practice. They can provide dermatologists with a starting point for decision-making, although available resources and patient preferences must always be borne in mind.