Primary Care Otolaryngology

Skin Cancer

percent with thick ones. It is important that the primary physician and dermatologist remain vigilant for darkly pigmented moles and those that have changed, bleed, are raised, or have irregular margins. Early detection and excision are critical to patient outcomes. The initial treatment of cutaneous melanomas after diagnosis and deter- mination of depth is wide (2 cm) surgical resection and, when appropri- ate, sentinel node lymphoscintigraphy to determine the first echelon of the draining lymphatic basin and identification of nodes at the highest risk for metastatic involvement. Afterwards, parotidectomy, selective nodal dissec- tion, bioimmunotherapy, and radiation may all be used to treat head and neck melanoma at some point in the patient’s care.

117

www.entnet.org