References

  1. 1.Bashline B. Skin cancer: squamous and basal cell carcinomas. FP Essent. 2019;481:17-22.
  2. 2.Zhou L, Zhong Y, Han L, et al. Global, regional, and national trends in the burden of melanoma and non-melanoma skin cancer: insights from the global burden of disease study 1990-2021. Sci Rep. 2025;15(1):5996.
  3. 3.Henrikson NB, Morrison CC, Blasi PR, et al. Behavioral counseling for skin cancer prevention: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2018;319(11):1143-1157.
  4. 4.Firnhaber JM. Basal cell and cutaneous squamous cell carcinomas: diagnosis and treatment. Am Fam Physician. 2020;102(6):339-346.
  5. 5.Wilkerson AH, Yau J, Pearlman RL, et al. Skin cancer knowledge, attitudes, beliefs, and prevention practices among beachgoers: a narrative review. Arch Dermatol Res. 2025;317(1):314.
  6. 6.Garbe C, Keim U, Gandini S, et al. Epidemiology of cutaneous melanoma and keratinocyte cancer in white populations 1943-2036. Eur J Cancer. 2021;152:18-25.
  7. 7.Pérez LL, Bashline B. Skin cancer: melanoma. FP Essent. 2019;481:11-16.
  8. 8.Lauters R, Brown AD, Harrington KA. Melanoma: diagnosis and treatment. Am Fam Physician. 2024;110(4):367-377.
  9. 9.National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Cancer stat facts: melanoma of the skin. https://seer.cancer.gov/statfacts/html/melan.html
  10. 10.Que SKT, Zwald FO, Schmults CD. Cutaneous squamous cell carcinoma: incidence, risk factors, diagnosis, and staging. J Am Acad Dermatol. 2018;78(2):237-247.
  11. 11.Chung S. Basal cell carcinoma. Arch Plast Surg. 2012;39(2):166-170.
  12. 12.Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol. 2018;78(3):540-559.
  13. 13.Wysong A. Squamous-cell carcinoma of the skin. N Engl J Med. 2023;388(24):2262-2273.
  14. 14.Mansouri B, Housewright CD. The treatment of actinic keratoses – the rule rather than the exception. JAMA Dermatol. 2017;153(11):1200.
  15. 15.Siegel RL, Miller KD, Wagle NS, et al. Cancer statistics, 2023. CA Cancer J Clin. 2023;73(1):17-48.
  16. 16.Guy GP Jr, Machlin SR, Ekwueme DU, et al. Prevalence and costs of skin cancer treatment in the U.S., 2002-2006 and 2007-2011. Am J Prev Med. 2015;48(2):183-187.
  17. 17.Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018;78(3):560-578.
  18. 18.Lukowiak TM, Aizman L, Perz A, et al. Association of age, sex, race, and geographic region with variation of the ratio of basal cell to cutaneous squamous cell carcinomas in the United States. JAMA Dermatol. 2020;156(11):1192-1198.
  19. 19.Waldman A, Schmults C. Cutaneous squamous cell carcinoma. Hematol Oncol Clin North Am. 2019;33(1):1-12.
  20. 20.Passeron T, Lim HW, Goh CL, et al. Photoprotection according to skin phototype and dermatoses: practical recommendations from an expert panel. J Eur Acad Dermatol Venereol. 2021;35(7):1460-1469.
  21. 21.Coleman W, Mariwalla K, Grimes P. Updating the Fitzpatrick Classification: the skin color and ethnicity scale. Dermatol Surg. 2023;49(8):725-731.
  22. 22.Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124(6):869-871.
  23. 23.Gupta V, Sharma VK. Skin typing: Fitzpatrick grading and others. Clin Dermatol. 2019;37(5):430-436.
  24. 24.Higgins S, Nazemi A, Chow M, et al. Review of nonmelanoma skin cancer in African Americans, Hispanics, and Asians. Dermatol Surg. 2018;44(7):903-910.
  25. 25.Shenenberger DW. Cutaneous malignant melanoma: a primary care perspective. Am Fam Physician. 2012;85(2):161-168.
  26. 26.Dinnes J, Deeks JJ, Grainge MJ, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. Visual inspection for diagnosing cutaneous melanoma in adults. Cochrane Database Syst Rev. 2018(12):CD013194.
  27. 27.Karia PS, Han J, Schmults CD. Cutaneous squamous cell carcinoma: estimated incidence of disease, nodal metastasis, and deaths from disease in the United States, 2012. J Am Acad Dermatol. 2013;68(6):957-966.
  28. 28.Mangione CM, Barry MJ, Nicholson WK, et al. Screening for skin cancer: US Preventive Services Task Force recommendation statement. JAMA. 2023;329(15):1290-1295.
  29. 29.National Cancer Institute. Surveillance, Epidemiology, and End Results Program. Cancer stat facts: common cancer sites. https://seer.cancer.gov/statfacts/html/common.html
  30. 30.Reinhart JP, Campbell EH, Proffer SL, et al. Incidence and mortality trends of primary cutaneous melanoma: a 50-year Rochester Epidemiologic Project study. JAAD Int. 2024;16:144-154.
  31. 31.Crum OM, Campbell EH, Reinhart JP, et al. Incidence trends of melanoma among young adults: an epidemiologic study in Olmsted County, Minnesota. J Am Acad Dermatol. 2023;89(2):369-370.
  32. 32.Didier AJ, Nandwani SV, Watkins D, et al. Patterns and trends in melanoma mortality in the United States, 1999-2020. BMC Cancer. 2024;24(1):790.
  33. 33.Siegel RL, Kratzer TB, Giaquinto AN, et al. Cancer statistics, 2025. CA Cancer J Clin. 2025;75(1):10-45.
  34. 34.Brady J, Kashlan R, Ruterbusch J, et al. Racial disparities in patients with melanoma: a multivariate survival analysis. Clin Cosmet Investig Dermatol. 2021;14:547-550.
  35. 35.Ekwueme DU, Guy GP Jr, Li C, et al. The health burden and economic costs of cutaneous melanoma mortality by race/ethnicity–United States, 2000 to 2006. J Am Acad Dermatol. 2011;65(5):S133-S143.
  36. 36.Leachman SA, Lucero OM, Sampson JE, et al. Identification, genetic testing, and management of hereditary melanoma. Cancer Metastasis Rev. 2017;36(1):77-90.
  37. 37.Ransohoff KJ, Jaju PD, Tang JY, et al. Familial skin cancer syndromes: increased melanoma risk. J Am Acad Dermatol. 2016;74(3):423-434.
  38. 38.National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology. Melanoma: cutaneous. Version 1.2026. https://www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdf
  39. 39.Wiesner T, Obenauf AC, Murali R, et al. Germline mutations in BAP1 predispose to melanocytic tumors. Nat Genet. 2011;43(10):1018-1021.
  40. 40.Adamson AS. The USPSTF I statement on skin cancer screening–not a disappointment but an opportunity. JAMA Dermatol. 2023;159(6):579-581.
  41. 41.Cronin T Jr. AAD statement on USPSTF recommendation on skin cancer screening. https://www.aad.org/news/aad-statement-uspstf-cancer-screeening
  42. 42.Sinclair R, Meah N, Arasu A. Skin checks in primary care. Aust J Gen Pract. 2019;48(9):614-619.
  43. 43.Sinclair R. Skin checks. Aust Fam Physician. 2012;41(7):464-469.
  44. 44.Berk-Krauss J, Polsky D, Stein JA. Mole mapping for management of pigmented skin lesions. Dermatol Clin. 2017;35(4):439-445.
  45. 45.Tromme I, Devleesschauwer B, Beutels P, et al. Selective use of sequential digital dermoscopy imaging allows a cost reduction in the melanoma detection process: a Belgian study of patients with a single or a small number of atypical nevi. PLoS One. 2014;9(10):e109339.
  46. 46.Garbe C, Amaral T, Peris K, et al.; European Dermatology Forum (EDF), the European Association of Dermato-Oncology (EADO), and the European Organization for Research and Treatment of Cancer (EORTC). European consensus-based interdisciplinary guideline for melanoma. Part 1: diagnostics: update 2022. Eur J Cancer. 2022;170:236-255.
  47. 47.Chuchu N, Dinnes J, Takwoingi Y, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. Teledermatology for diagnosing skin cancer in adults. Cochrane Database Syst Rev. 2018(12):CD013193.
  48. 48.Salinas MP, Sepúlveda J, Hidalgo L, et al. A systematic review and meta-analysis of artificial intelligence versus clinicians for skin cancer diagnosis. NPJ Digit Med. 2024;7(1):125.
  49. 49.Islam S, Wishart GC, Walls J, et al. Leveraging AI and patient metadata to develop a novel risk score for skin cancer detection. Sci Rep. 2024;14(1):20842.
  50. 50.Li Z, Koban KC, Schenck TL, et al. Artificial intelligence in dermatology image analysis: current developments and future trends. J Clin Med. 2022;11(22):6826.
  51. 51.Liu Y, Primiero CA, Kulkarni V, et al. Artificial intelligence for the classification of pigmented skin lesions in populations with skin of color: a systematic review. Dermatology. 2023;239(4):499-513.
  52. 52.Freeman K, Dinnes J, Chuchu N, et al. Algorithm based smartphone apps to assess risk of skin cancer in adults: systematic review of diagnostic accuracy studies. BMJ. 2020;368:m127.
  53. 53.Menzies SW, Sinz C, Menzies M, et al. Comparison of humans versus mobile phone-powered artificial intelligence for the diagnosis and management of pigmented skin cancer in secondary care. Lancet Digit Health. 2023;5(10):e679-e691.
  54. 54.Montague M, Borland R, Sinclair C. Slip! Slop! Slap! and SunSmart, 1980-2000: skin cancer control and 20 years of population-based campaigning. Health Educ Behav. 2001;28(3):290-305.
  55. 55.Buller DB, Berteletti J, Heckman C, et al. Bills to restrict access to and harm from indoor tanning facilities in US state legislatures, 1992-2023. Am J Public Health. 2025;115(2):191-200.
  56. 56.Guan LL, Lim HW, Mohammad TF. Sunscreens and photoaging: a review of current literature. Am J Clin Dermatol. 2021;22(6):819-828.
  57. 57.Pérez LL, Bashline B. Skin cancer: prevention. FP Essent. 2019;481:28-31.
  58. 58.Isedeh P, Osterwalder U, Lim HW. Teaspoon rule revisited: proper amount of sunscreen application. Photodermatol Photoimmunol Photomed. 2013;29(1):55-56.
  59. 59.Salih H, Psomadakis C, George SMC. Sunscreens: a narrative review. Skin Health Dis. 2024;4(6):e432.
  60. 60.Sabzevari N, Qiblawi S, Norton SA, et al. Sunscreens: UV filters to protect us: part 1. Int J Womens Dermatol. 2021;7(1):28-44.
  61. 61.Mansour MR, Abushukur Y, Mohammad TF. Navigating the changing landscape of reef-safe/reef-friendly sunscreens: current bans and accessibility. Arch Dermatol Res. 2024;316(6):310.
  62. 62.Ou-Yang H, Stanfield J, Cole C, et al. High-SPF sunscreens (SPF ≥ 70) may provide ultraviolet protection above minimal recommended levels by adequately compensating for lower sunscreen user application amounts. J Am Acad Dermatol. 2012;67(6):1220-1227.
  63. 63.Department of Health and Human Services. US Food and Drug Administration. Labeling and effectiveness testing; sunscreen drug products for over-the-counter human use. Final rule. Fed Regist. 2011;76(117):35620-35665.
  64. 64.Wang SQ, Xu H, Stanfield JW, et al. Comparison of ultraviolet A light protection standards in the United States and European Union through in vitro measurements of commercially available sunscreens. J Am Acad Dermatol. 2017;77(1):42-47.
  65. 65.Kanellis VG. Ultraviolet radiation sensors: a review. Biophys Rev. 2019;11(4):895-899.
  66. 66.Horsham C, Ford H, Hacker E. Promoting sunscreen use in adolescents playing outdoor sports using UV detection stickers. Prev Med Rep. 2020;19:101166.
  67. 67.Ford H, Herbert J, Horsham C, et al. Internet of things smart sunscreen station. J Med Internet Res. 2020;22(5):e17079.
  68. 68.Chen AC, Martin AJ, Choy B, et al. A phase 3 randomized trial of nicotinamide for skin-cancer chemoprevention. N Engl J Med. 2015;373(17):1618-1626.
  69. 69.Nehal KS, Bichakjian CK. Update on keratinocyte carcinomas. N Engl J Med. 2018;379(4):363-374.
  70. 70.Bhullar S, Christensen SR. Effectiveness of acitretin for skin cancer prevention in immunosuppressed and nonimmunosuppressed patients. J Am Acad Dermatol. 2024;90(4):821-822.
  71. 71.Breglio KF, Knox KM, Hwang J, et al. Nicotinamide for skin cancer chemoprevention. JAMA Dermatol. 2025;161(11):1140-1147.
  72. 72.Massey PR, Schmults CD, Li SJ, et al. Consensus-based recommendations on the prevention of squamous cell carcinoma in solid organ transplant recipients. JAMA Dermatol. 2021;157(10):1219-1226.
  1. 1.Johr RH, Stolz W. Dermoscopy: An Illustrated Self-Assessment Guide. 2nd ed. McGraw Hill Education; 2015.
  2. 2.Dinnes J, Deeks JJ, Chuchu N, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. Visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults. Cochrane Database Syst Rev. 2018(12):CD011901.
  3. 3.Klein CM, Sivesind TE, Dellavalle RP. From the Cochrane Library: visual inspection and dermoscopy, alone or in combination, for diagnosing keratinocyte skin cancers in adults. JMIR Dermatol. 2024;7:e41657.
  4. 4.Dinnes J, Deeks JJ, Chuchu N, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. Dermoscopy, with and without visual inspection, for diagnosing melanoma in adults. Cochrane Database Syst Rev. 2018(12):CD011902.
  5. 5.Dinnes J, Deeks JJ, Grainge MJ, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. Visual inspection for diagnosing cutaneous melanoma in adults. Cochrane Database Syst Rev. 2018(12):CD013194.
  6. 6.Marghoob AA, Usatine RP, Jaimes N. Dermoscopy for the family physician. Am Fam Physician. 2013;88(7):441-450.
  7. 7.Lu MD, Usatine R, Holt J, et al. Dermoscopy Training in Family Medicine Residencies: A CERA Survey of Program Directors. Fam Med. 2023;55(4):259-262.
  8. 8.Lauters R, Brown AD, Harrington KA. Melanoma: diagnosis and treatment. Am Fam Physician. 2024;110(4):367-377.
  9. 9.Goldsmith SM, Cognetta AB Jr. Time to move forward after the report of the AAD Task Force for the ABCDEs of melanoma. J Am Acad Dermatol. 2015;73(4):e149-e150.
  10. 10.Tsao H, Olazagasti JM, Cordoro KM, et al.; American Academy of Dermatology Ad Hoc Task Force for the ABCDEs of Melanoma. Early detection of melanoma: reviewing the ABCDEs. J Am Acad Dermatol. 2015;72(4):717-723.
  11. 11.Scope A, Dusza SW, Halpern AC, et al. The “ugly duckling” sign: agreement between observers. Arch Dermatol. 2008;144(1):58-64.
  12. 12.Dinnes J, Deeks JJ, Saleh D, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. Reflectance confocal microscopy for diagnosing cutaneous melanoma in adults. Cochrane Database Syst Rev. 2018(12):CD013190.
  13. 13.Navarrete-Dechent C, Cordova M, Aleissa S, et al. Reflectance confocal microscopy confirms residual basal cell carcinoma on clinically negative biopsy sites before Mohs micrographic surgery: a prospective study. J Am Acad Dermatol. 2019;81(2):417-426.
  14. 14.Stevens HP, Pampena R, Farnetani F, et al. Reflectance confocal microscopy in diagnosing basal cell carcinoma in the UK: a prospective observational single-centre trial. Br J Dermatol. 2025;192(2):206-214.
  15. 15.Danescu S, Negrutiu M, Focsan M, et al. An overview of cutaneous squamous cell carcinoma imaging diagnosis methods. Front Med (Lausanne). 2024;11:1388835.
  16. 16.Ferrante Di Ruffano L, Dinnes J, Deeks JJ, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. Optical coherence tomography for diagnosing skin cancer in adults. Cochrane Database Syst Rev. 2018(12):CD013189.
  17. 17.Dinnes J, Bamber J, Chuchu N, et al.; Cochrane Skin Cancer Diagnostic Test Accuracy Group. High-frequency ultrasound for diagnosing skin cancer in adults. Cochrane Database Syst Rev. 2018(12):CD013188.
  18. 18.Tamas T, Dinu C, Lenghel LM, et al. High-frequency ultrasound in diagnosis and treatment of non-melanoma skin cancer in the head and neck region. Diagnostics (Basel). 2023;13(5):1002.
  19. 19.Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018;78(3):560-578.
  20. 20.Bashline B. Skin cancer: squamous and basal cell carcinomas. FP Essent. 2019;481:17-22.
  21. 21.National Comprehensive Cancer Network. NCCN clinical practice guidelines in oncology: cutaneous melanoma. Version 1.2026. https://www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdf
  22. 22.Firnhaber JM. Basal cell and cutaneous squamous cell carcinomas: diagnosis and treatment. Am Fam Physician. 2020;102(6):339-346.
  23. 23.Naik PP, Desai MB. Basal cell carcinoma: a narrative review on contemporary diagnosis and management. Oncol Ther. 2022;10(2):317-335.
  24. 24.Reiter O, Mimouni I, Dusza S, et al. Dermoscopic features of basal cell carcinoma and its subtypes: a systematic review. J Am Acad Dermatol. 2021;85(3):653-664.
  25. 25.Pyne JH, Fishburn P, Dicker A, et al. Infiltrating basal cell carcinoma: a stellate peri-tumor dermatoscopy pattern as a clue to diagnosis. Dermatol Pract Concept. 2015;5(2):21-26.
  26. 26.Șerbănescu MS, Bungărdean RM, Georgiu C, et al. Nodular and micronodular basal cell carcinoma subtypes are different tumors based on their morphological architecture and their interaction with the surrounding stroma. Diagnostics (Basel). 2022;12(7):1636.
  27. 27.Smith V, Walton S. Treatment of facial Basal cell carcinoma: a review. J Skin Cancer. 2011;2011:380371.
  28. 28.Kamyab-Hesari K, Seirafi H, Naraghi ZS, et al. Diagnostic accuracy of punch biopsy in subtyping basal cell carcinoma. J Eur Acad Dermatol Venereol. 2014;28(2):250-253.
  29. 29.Lallas A, Argenziano G, Kyrgidis A, et al. Dermoscopy uncovers clinically undetectable pigmentation in basal cell carcinoma. Br J Dermatol. 2014;170(1):192-195.
  30. 30.Marzuka AG, Book SE. Basal cell carcinoma: pathogenesis, epidemiology, clinical features, diagnosis, histopathology, and management. Yale J Biol Med. 2015;88(2):167-179.
  31. 31.Namiki T, Nojima K, Hanafusa T, et al. Superficial basal cell carcinoma: dermoscopic and histopathological features of multiple small erosions. Australas J Dermatol. 2018;59(1):69-71.
  32. 32.Li Y, Tran T, Lee BA, et al. Patient characteristics and outcomes in clinically misdiagnosed patients with Merkel cell carcinoma. J Surg Res. 2025;309:71-79.
  33. 33.Christensen RE, Elston DM, Worley B, et al. Dermatopathologic features of cutaneous squamous cell carcinoma and actinic keratosis: consensus criteria and proposed reporting guidelines. J Am Acad Dermatol. 2023;88(6):1317-1325.
  34. 34.Fitzpatrick JE, Morelli JG. Dermatology Secrets Plus. FitzpatrickJEMorelliJG. Dermatology Secrets Plus. 5th ed. Elsevier; 2016.
  35. 35.Shenenberger DW. Cutaneous malignant melanoma: a primary care perspective. Am Fam Physician. 2012;85(2):161-168.
  36. 36.Bobos M. Histopathologic classification and prognostic factors of melanoma: a 2021 update. Ital J Dermatol Venereol. 2021;156(3):300-321.
  37. 37.Dass SE, Huizenga T, Farshchian M, et al. Comparison of SOX-10, HMB-45, and Melan-A in benign melanocytic lesions. Clin Cosmet Investig Dermatol. 2021;14:1419-1425.
  38. 38.Duffy K, Grossman D. The dysplastic nevus: from historical perspective to management in the modern era: part I. Historical, histologic, and clinical aspects. J Am Acad Dermatol. 2012;67(1):1.e1-1.e16.
  39. 39.Pérez LL, Bashline B. Skin cancer: melanoma. FP Essent. 2019;481:11-16.
  40. 40.Nadelmann ER, Singh AK, Abbruzzese M, et al. Acral melanoma in skin of color: current insights and future directions: a narrative review. Cancers (Basel). 2025;17(3):468.
  41. 41.Lynch HT, Shaw TG. Familial atypical multiple mole melanoma (FAMMM) syndrome: history, genetics, and heterogeneity. Fam Cancer. 2016;15(3):487-491.
  42. 42.Swetter SM, Tsao H, Bichakjian CK, et al. Guidelines of care for the management of primary cutaneous melanoma. J Am Acad Dermatol. 2019;80(1):208-250.
  43. 43.Gong HZ, Zheng HY, Li J. Amelanotic melanoma. Melanoma Res. 2019;29(3):221-230.
  1. 1.McIntyre WJ, Downs MR, Bedwell SA. Treatment options for actinic keratoses. Am Fam Physician. 2007;76(5):667-671.
  2. 2.West DA, Aires DJ. Treatment of actinic keratoses with topical fluorouracil. Am Fam Physician. 2010;81(10):1186-1188.
  3. 3.Jansen MHE, Kessels JPHM, Nelemans PJ, et al. Randomized trial of four treatment approaches for actinic keratosis. N Engl J Med. 2019;380(10):935-946.
  4. 4.Worley B, Harikumar V, Reynolds K, et al. Treatment of actinic keratosis: a systematic review. Arch Dermatol Res. 2023;315(5):1099-1108.
  5. 5.Kandolf L, Peris K, Malvehy J, et al. European consensus-based interdisciplinary guideline for diagnosis, treatment and prevention of actinic keratoses, epithelial UV-induced dysplasia and field cancerization on behalf of European Association of Dermato-Oncology, European Dermatology Forum, European Academy of Dermatology and Venereology and Union of Medical Specialists (Union Européenne des Médecins Spécialistes). J Eur Acad Dermatol Venereol. 2024;38(6):1024-1047.
  6. 6.Siegel JA, Korgavkar K, Weinstock MA. Current perspective on actinic keratosis: a review. Br J Dermatol. 2017;177(2):350-358.
  7. 7.Bickers DR, Lim HW, Margolis D, et al. The burden of skin diseases: 2004 a joint project of the American Academy of Dermatology Association and the Society for Investigative Dermatology. J Am Acad Dermatol. 2006;55(3):490-500.
  8. 8.Flohil SC, van der Leest RJT, Dowlatshahi, et al. Prevalence of actinic keratosis and its risk factors in the general population: the Rotterdam Study. J Invest Dermatol. 2013;133(8):1971-1978.
  9. 9.Bruner P, Bashline B. Skin cancer: precancers. FP Essent. 2019;481:23-27.
  10. 10.Johr R, Stolz W. Dermoscopy: An Illustrated Self-Assessment Guide. 2nd ed. McGraw Hill Education; 2015.
  11. 11.de Berker D, McGregor JM, Mohd Mustapa MF, et al. British Association of Dermatologists’ guidelines for the care of patients with actinic keratosis 2017. Br J Dermatol. 2017;176(1):20-43.
  12. 12.Gupta AK, Paquet M, Villanueva E, et al. Interventions for actinic keratoses. Cochrane Database Syst Rev. 2012(12):CD004415.
  13. 13.Weinstock MA, Thwin SS, Siegel JA, et al.; Veterans Affairs Keratinocyte Carcinoma Chemoprevention Trial (VAKCC) Group. Chemoprevention of basal and squamous cell carcinoma with a single course of fluorouracil, 5%, cream: a randomized clinical trial. JAMA Dermatol. 2018;154(2):167-174.
  14. 14.Eisen DB, Asgari MM, Bennett DD, et al. Guidelines of care for the management of actinic keratosis. J Am Acad Dermatol. 2021;85(4):e209-e233.
  15. 15.Willenbrink TJ, Ruiz ES, Cornejo CM, et al. Field cancerization: definition, epidemiology, risk factors, and outcomes. J Am Acad Dermatol. 2020;83(3):709-717.
  16. 16.Stockfleth E. The paradigm shift in treating actinic keratosis: a comprehensive strategy. J Drugs Dermatol. 2012;11(12):1462-1467.
  17. 17.Aggarwal I, Puyana C, Chandan N, et al. Field cancerization therapies for the management of actinic keratosis: an updated review. Am J Clin Dermatol. 2024;25(3):391-405.
  18. 18.Holzer G, Pinkowicz A, Radakovic S, et al. Randomized controlled trial comparing 35% trichloroacetic acid peel and 5-aminolaevulinic acid photodynamic therapy for treating multiple actinic keratosis. Br J Dermatol. 2017;176(5):1155-1161.
  19. 19.UpToDate. Lexicomp Drug Monographs. https://www.uptodate.com
  20. 20.Cunningham TJ, Tabacchi M, Eliane JP, et al. Randomized trial of calcipotriol combined with 5-fluorouracil for skin cancer precursor immunotherapy. J Clin Invest. 2017;127(1):106-116.
  21. 21.Rosenberg AR, Tabacchi M, Ngo KH, et al. Skin cancer precursor immunotherapy for squamous cell carcinoma prevention. JCI Insight. 2019;4(6):e125476.
  22. 22.Li Pomi F, Vaccaro M, Pallio G, et al. Tirbanibulin 1% ointment for actinic keratosis: results from a real-life study. Medicina (Kaunas). 2024;60(2):225.
  23. 23.Firnhaber JM. Basal cell and cutaneous squamous cell carcinomas: diagnosis and treatment. Am Fam Physician. 2020;102(6):339-346.
  24. 24.Bashline B. Skin cancer: squamous and basal cell carcinomas. FP Essent. 2019;481:17-22.
  25. 25.Sohn GK, Keniston K, Kannan S, et al. Characteristics of superficial basal cell carcinomas containing more aggressive subtypes on final histopathologic diagnosis. J Drugs Dermatol. 2021;20(3):283-288.
  26. 26.Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of basal cell carcinoma. J Am Acad Dermatol. 2018;78(3):540-559.
  27. 27.Al-Ghamdi Y. Basal cell carcinoma: shave biopsy versus punch biopsy technique in subtype diagnosis. J Am Acad Dermatol. 2002;46(4):643.
  28. 28.Schmults CD, Blitzblau R, Aasi SZ, et al. Basal cell skin cancer, version 2.2024, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2023;21(11):1181-1203.
  29. 29.Thomson J, Hogan S, Leonardi-Bee J, et al. Interventions for basal cell carcinoma of the skin. Cochrane Database Syst Rev. 2020(11):CD003412.
  30. 30.Cheng M, Chang R, Dong F, et al. 51301. Examining the efficacy of cryosurgery for the treatment of basal cell carcinoma and squamous cell carcinoma: a prospective study. J Am Acad Dermatol. 2024;91(3):AB211.
  31. 31.Quazi SJ, Aslam N, Saleem H, et al. Surgical margin of excision in basal cell carcinoma: a systematic review of literature. Cureus. 2020;12(7):e9211.
  32. 32.Stevens JS, Murad F, Smile TD, et al. Validation of the 2022 National Comprehensive Cancer Network risk stratification for cutaneous squamous cell carcinoma. JAMA Dermatol. 2023;159(7):728-735.
  33. 33.American Academy of Dermatology Association. Mohs Surgery Appropriate Use Criteria (AUC) app. https://www.aad.org/member/publications/apps/mohs
  34. 34.Wilson M, Johnson RP, Senft SC, et al. Advanced basal cell carcinoma: what dermatologists need to know about treatment. J Am Acad Dermatol. 2022;86(6):S14-S24.
  35. 35.Fitzpatrick JE, Morelli JG. Dermatology Secrets Plus. 5th ed. Elsevier; 2016.
  36. 36.Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma. Part 1: diagnostics and prevention-update 2023. Eur J Cancer. 2023;193:113251.
  37. 37.Keohane SG, Botting J, Budny PG, et al. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma 2020. Br J Dermatol. 2021;184(3):401-414.
  38. 38.Kim JYS, Kozlow JH, Mittal B, et al. Guidelines of care for the management of cutaneous squamous cell carcinoma. J Am Acad Dermatol. 2018;78(3):560-578.
  39. 39.Schmults CD, Blitzblau R, Aasi SZ, et al. NCCN guidelines® insights: squamous cell skin cancer, version 1.2022. J Natl Compr Canc Netw. 2021;19(12):1382-1394.
  40. 40.Veverka KK, Stratman EJ. Electrodesiccation and curettage for squamous cell carcinoma in situ: the effect of anatomic location on local recurrence. Dermatol Surg. 2023;49(9):821-824.
  41. 41.Ahmady S, Nelemans PJ, Kelleners-Smeets NWJ, et al. Surgical excision versus topical 5% 5-fluorouracil and photodynamic therapy in treatment of Bowen’s disease: a multicenter randomized controlled trial. J Am Acad Dermatol. 2024;90(1):58-65.
  42. 42.Patel GK, Goodwin R, Chawla M, et al. Imiquimod 5% cream monotherapy for cutaneous squamous cell carcinoma in situ (Bowen’s disease): a randomized, double-blind, placebo-controlled trial. J Am Acad Dermatol. 2006;54(6):1025-1032.
  43. 43.Sharma A, Birnie AJ, Bordea C, et al. British Association of Dermatologists guidelines for the management of people with cutaneous squamous cell carcinoma in situ (Bowen disease) 2022. Br J Dermatol. 2023;188(2):186-194.
  44. 44.UpToDate Lexidrug. Fluorouracil (topical). https://www.uptodate.com/contents/fluorouracil-topical-drug-information
  45. 45.Lansbury L, Bath-Hextall F, Perkins W, et al. Interventions for non-metastatic squamous cell carcinoma of the skin: systematic review and pooled analysis of observational studies. BMJ. 2013;347:f6153.
  46. 46.Brodland DG, Zitelli JA. Surgical margins for excision of primary cutaneous squamous cell carcinoma. J Am Acad Dermatol. 1992;27(2):241-248.
  47. 47.Kauvar ANB, Arpey CJ, Hruza G, et al. Consensus for nonmelanoma skin cancer treatment, part II: squamous cell carcinoma, including a cost analysis of treatment methods. Dermatol Surg. 2015;41(11):1214-1240.
  48. 48.Stratigos AJ, Garbe C, Dessinioti C, et al. European consensus-based interdisciplinary guideline for invasive cutaneous squamous cell carcinoma: part 2. Treatment-update 2023. Eur J Cancer. 2023;193:113252.
  49. 49.Mager L, Gardeen S, Carr DR, et al. Cemiplimab for the treatment of advanced cutaneous squamous cell carcinoma: appropriate patient selection and perspectives. Clin Cosmet Investig Dermatol. 2023;16:2135-2142.
  50. 50.Rischin D, Porceddu S, Day F, et al. Adjuvant cemiplimab or placebo in high-risk cutaneous squamous-cell carcinoma. N Engl J Med. 2025;393(8):774-785.
  51. 51.Hughes BGM, Munoz-Couselo E, Mortier L, et al. Pembrolizumab for locally advanced and recurrent/metastatic cutaneous squamous cell carcinoma (KEYNOTE-629 study): an open-label, nonrandomized, multicenter, phase II trial. Ann Oncol. 2021;32(10):1276-1285.
  1. 1.Lauters R, Brown AD, Harrington KCA. Melanoma: diagnosis and treatment. Am Fam Physician. 2024;110(4):367-377.
  2. 2.Fitzpatrick TB. The validity and practicality of sun-reactive skin types I through VI. Arch Dermatol. 1988;124(6):869-871.
  3. 3.Gershenwald JE, Scolyer RA, Hess KR, et al. Melanoma staging: evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. CA Cancer J Clin. 2017;67(6):472-492.
  4. 4.Shenenberger DW. Cutaneous malignant melanoma: a primary care perspective. Am Fam Physician. 2012;85(2):161-168.
  5. 5.Pérez LL, Bashline B. Skin cancer: melanoma. FP Essent. 2019;481:11-16.
  6. 6.Keung EZ, Gershenwald JE. The eighth edition American Joint Committee on Cancer (AJCC) melanoma staging system: implications for melanoma treatment and care. Expert Rev Anticancer Ther. 2018;18(8):775-784.
  7. 7.Swetter SM, Tsao H, Bichakjian CK, et al. Guidelines of care for the management of primary cutaneous melanoma. J Am Acad Dermatol. 2019;80(1):208-250.
  8. 8.National Comprehensive Cancer Network. Melanoma: cutaneous. Version 1.2026. https://www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdf
  9. 9.Dinnes J, Deeks JJ, Grainge MJ, et al. Visual inspection for diagnosing cutaneous melanoma in adults. Cochrane Database Syst Rev. 2018(12):CD013194.
  10. 10.Cust AE, Scolyer RA. Melanoma in situ–getting the diagnosis and prognosis right. JAMA Dermatol. 2023;159(7):699-701.
  11. 11.Wong SL, Faries MB, Kennedy EB, et al. Sentinel lymph node biopsy and management of regional lymph nodes in melanoma: American Society of Clinical Oncology and Society of Surgical Oncology clinical practice guideline update. J Clin Oncol. 2018;36(4):399-413.
  12. 12.Luke JJ, Ascierto PA, Khattak MA, et al. Pembrolizumab versus placebo as adjuvant therapy in resected stage IIB or IIC melanoma: final analysis of distant metastasis-free survival in the phase III KEYNOTE-716 study. J Clin Oncol. 2024;42(14):1619-1624.
  13. 13.Blank CU, Lucas MW, Scolyer RA, et al. Neoadjuvant nivolumab and ipilimumab in resectable stage III melanoma. N Engl J Med. 2024;391(18):1696-1708.
  14. 14.Tarhini AA, Castellano E, Eljilany I. Treatment of stage III resectable melanoma-adjuvant and neoadjuvant approaches. Cancer J. 2024;30(2):54-70.
  15. 15.Long GV, Menzies AM, Scolyer RA. Neoadjuvant checkpoint immunotherapy and melanoma: the time is now. J Clin Oncol. 2023;41(17):3236-3248.
  16. 16.Gupta S, Shaughnessy M, Rashid S, et al. Lentigo maligna part II: management. J Am Acad Dermatol. 2025;93(6):1399-1410.
  17. 17.Ellison PM, Zitelli JA, Brodland DG. Mohs micrographic surgery for melanoma: a prospective multicenter study. J Am Acad Dermatol. 2019;81(3):767-774.
  18. 18.Brodland DG. Mohs micrographic surgery for melanoma: evidence, controversy, and a critical review of excisional margin guidelines. Dermatol Clin. 2023;41(1):79-88.
  19. 19.National Comprehensive Cancer Network. NCCN guidelines for patients. Melanoma. https://www.nccn.org/patients/guidelines/content/PDF/melanoma-patient.pdf
  20. 20.Goldstein AM, Chan M, Harland M, et al.; Lund Melanoma Study Group. Melanoma Genetics Consortium (GenoMEL). Features associated with germline CDKN2A mutations: a GenoMEL study of melanoma-prone families from three continents. J Med Genet. 2007;44(2):99-106.
  21. 21.Davis EJ, Johnson DB, Sosman JA, et al. Melanoma: what do all the mutations mean? Cancer. 2018;124(17):3490-3499.
  22. 22.Gosman LM, Țăpoi DA, Costache M. cutaneous melanoma: a review of multifactorial pathogenesis, immunohistochemistry, and emerging biomarkers for early detection and management. Int J Mol Sci. 2023;24(21):15881.
  23. 23.American Cancer Society. What happens during genetic testing for cancer risk? https://www.cancer.org/cancer/risk-prevention/genetics/genetic-testing-for-cancer-risk/what-happens-during-genetic-testing-for-cancer.html
  24. 24.Berwick M, Begg CB, Armstrong BK, et al. Interaction of CDKN2A and sun exposure in the etiology of melanoma in the general population. J Invest Dermatol. 2011;131(12):2500-2503.
  25. 25.Bruno W, Dalmasso B, Barile M, et al. Predictors of germline status for hereditary melanoma: 5 years of multi-gene panel testing within the Italian Melanoma Intergroup. ESMO Open. 2022;7(4):100525.
  26. 26.Leachman SA, Lucero OM, Sampson JE, et al. Identification, genetic testing, and management of hereditary melanoma. Cancer Metastasis Rev. 2017;36(1):77-90.
  27. 27.Perez M, Abisaad JA, Rojas KD, et al. Skin cancer: primary, secondary, and tertiary prevention. Part I. J Am Acad Dermatol. 2022;87(2):255-268.
  28. 28.Garbe C, Amaral T, Peris K, et al. European consensus-based interdisciplinary guideline for melanoma. Part 1: diagnostics: update 2022. Eur J Cancer. 2022;170:236-255.
  29. 29.Johnson DB, Smalley KSM, Sosman JA. Molecular pathways: targeting NRAS in melanoma and acute myelogenous leukemia. Clin Cancer Res. 2014;20(16):4186-4192.
  30. 30.Curti BD, Faries MB. Recent advances in the treatment of melanoma. N Engl J Med. 2021;384(23):2229-2240.
  31. 31.Haugh AM, Osorio RC, Francois RA, et al. Targeted DNA sequencing of cutaneous melanoma identifies prognostic and predictive alterations. Cancers (Basel). 2024;16(7):1347.
  32. 32.Manrique-Silva E, Rachakonda S, Millán-Esteban D, et al. Clinical, environmental and histological distribution of BRAF, NRAS and TERT promoter mutations among patients with cutaneous melanoma. Br J Dermatol. 2021;184(3):504-513.
  33. 33.Hoeijmakers LL, Reijers ILM, Blank CU. Biomarker-driven personalization of neoadjuvant immunotherapy in melanoma. Cancer Discov. 2023;13(11):2319-2338.
  34. 34.Eggermont AMM, Blank CU, Mandala M, et al. Adjuvant pembrolizumab versus placebo in resected stage III melanoma. N Engl J Med. 2018;378(19):1789-1801.
  35. 35.Amir M, Khan ZA, Asad A, et al. Role of neoadjuvant pembrolizumab in advanced melanoma. Semin Oncol. 2024;51(5):161-162.
  36. 36.Seth R, Agarwala SS, Messersmith H, et al. Systemic therapy for melanoma: ASCO guideline update. J Clin Oncol. 2023;41(30):4794-4820.
  37. 37.Gorry C, McCullagh L, O’Donnell H, et al. Neoadjuvant treatment for stage III and IV cutaneous melanoma. Cochrane Database Syst Rev. 2023(1):CD012974.
  38. 38.Weber J, Mandala M, Del Vecchio M, et al. CheckMate 238 collaborators. adjuvant nivolumab versus ipilimumab in resected stage III or IV melanoma. N Engl J Med. 2017;377(19):1824-1835.

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