Oto Primary Care FINALhigh

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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.