SKIN CANCER RECONSTRUCTION
Skin Cancer commonly involves the skin of the eyelid and adjacent facial areas. Eyelid skin cancer, which most commonly occurs on the lower eyelid, usually presents as a painless elevated nodule. Other signs of eyelid cancer include missing eyelashes, ulceration, bleeding and crusting. Dr. Cook performs in office biopsies to confirm the diagnosis of skin cancer if any of the above eyelid signs are present.
The most common type of eyelid skin cancer is basal cell carcinoma, with squamous cell carcinoma being the second most prevalent. Both types of skin cancer are typically slow growing and tend to invade locally. Dr. Cook has written the definitive paper on the types and frequencies of skin cancers that occur around the eyelids. More aggressive types of eyelid skin cancer, which can metastasize (spread to other parts of the body), include melanoma and sebaceous cell carcinoma. Therefore, early detection with prompt surgical intervention is very important in the management of eyelid skin cancers.
The treatment of eyelid skin cancer involves one of two methods. The most common method of removal of eyelid and facial skin cancer is through a technique called Mohs’ Micrographic excision (or Mohs’ surgery). Frederick Mohs was a dermatologist and pathologist who developed this technique at the University of Wisconsin-Madison, where Dr. Cook trained. Using this method, the skin cancer is removed in small amounts and examined at the time of removal to make sure no skin cancer is left behind. This is the method that has the lowest recurrence rate. Mohs’ surgery and the subsequent repair are done in the office. The second method is through excision of the tumor under frozen section (the pathologist confirms that the margins are free of cancer while the patient is in the operating room) with reconstruction of the eyelid defect. The use of frozen section biopsy confirms that the tumor is completely removed. Dr. Cook will choose the reconstructive surgical technique based upon the size and location of the eyelid skin cancer.
