Recommendations for the management of cutaneous squamous cell carcinoma: a systematic multidisciplinary Delphi consensus approach.

Background: There are gaps and unanswered questions in clinical guidelines regarding several aspects of the management of patients with cutaneous squamous cell carcinoma (cSCC).

Methods: A scientific committee of ten cSCC specialists in Spain (dermatology, medical oncology, oral and maxillofacial surgery, plastic surgery, and radiotherapy) used ADAPTE methodology to develop recommendations by: (i) identifying clinical questions not fully answered by clinical practice guidelines; (ii) systematically reviewing the literature (published between November 2017 and July 2023 in PubMed and the Cochrane database) and grading the evidence (using Oxford levels); (iii) developing recommendations and assessing those with no consensus among the scientific committee or with evidence level 3-5 or strength of recommendation under C or D in a two-round Delphi method; and (iv) developing the final recommendations in the form of answers to key clinical questions, grading the strength of recommendation. An external group of 32 experts plus the members of the committee participated in both Delphi rounds, evaluating the appropriateness and need of the recommendations.

A nodule on the scalp as the first sign of extranodal disease in medullary thyroid carcinoma.

Medullary carcinoma of the thyroid gland accounts for only 5-10% of thyroid carcinomas. Also, metastases to the skin of malignant tumors are infrequently (2-9% of patients). In the case herein reported in a 64-year old woman, a metastatic nodule on the scalp was the presenting clinical manifestation of a medullary thyroid carcinoma.

The Role of Reflectance Confocal Microscopy in Clinical Trials for Tumor Monitoring.

Reflectance confocal microscopy (RCM) allows the evaluation with superb accuracy of some skin tumors before, during, and after treatment. In clinical trials RCM has been shown to provide useful information for evaluation of efficacy of topical or systemic medication. With the recent introduction of handheld RCM a fast examination of the tumor can be done in minutes.

Glowing in the Dark: Use of Confocal Microscopy in Dark Pigmented Lesions.

Reflectance confocal microscopy patterns and structures of clinically dark lesions are described. Because many of the dark lesions have melanin in superficial skin layers these lesions show great semiology by confocal. Limitations and pitfalls of reflectance confocal microscopy in clinically dark lesions are also detailed.