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  • Presentation

Prevention and Active Surveillance for Keratinocyte Carcinoma

Description

The presentation covers strategies for preventing and monitoring keratinocyte carcinoma, particularly focusing on topical therapies and active surveillance. Key points include the effectiveness of combining topical 5-fluorouracil (5FU) with calcipotriene, which showed a significant reduction in squamous cell carcinoma (SCC) at three years, whereas monotherapy had limited long-term effects. Nicotinamide, though beneficial, has shown mixed results in immunocompromised patients, prompting caution regarding its use in these populations. The discussion on active surveillance highlights its suitability for select patients, particularly the elderly with low-risk basal cell carcinomas (BCCs), and emphasizes the importance of patient involvement and monitoring for tumor growth. Active surveillance can be an option for those who prefer not to undergo immediate treatment, as BCCs in low-risk groups show slow growth rates. Overall, the speaker encourages more clinicians to consider these strategies, advocating for personalized discussions with patients regarding treatment options.

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Conclusions

  • Topical treatment with compounded 5-FU and calcipotriol shows a durable response in preventing squamous cell carcinoma at three years.
  • Nicotinamide effectively reduces the risk of keratinocyte carcinoma in immunocompetent patients, but its effectiveness in immunocompromised individuals remains uncertain due to underpowered studies.
  • Active surveillance is a viable option for elderly patients with basal cell carcinoma who are asymptomatic and have limited life expectancy, as the risk of metastasis is extremely low.
  • Counseling patients about expected side effects and management options enhances tolerance and satisfaction with treatments.
  • Shave saucerization can be an effective method for diagnosing and treating small, low-risk skin cancers, especially in older patients with multiple comorbidities.
  • Clinicians should consider consulting with cardiology when prescribing nicotinamide for patients with significant cardiovascular histories due to emerging safety concerns.
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