At Home Christian Jessen 2014 - 373

|promotion|
of choice. The tumour is removed with
a margin of normal-looking tissue around it
(since cancerous cells extend beyond the visible
tumour) and the area is then reconstructed by
mobilising healthy adjacent tissues into the area
of excision. It is important that the complete
excision of the tumour is achieved because
recurrent tumours are more challenging to cure.
Mastering Mohs
Mohs micrographic surgery is a technique
developed in the US by general surgeon,
Frederic E. Mohs, for the treatment of certain
types of skin cancer. It is now practiced in
specialist centres across the world. Mohs offers
the best chance of complete cure for both new
and recurrent basal cell carcinoma (the most
common type of skin cancer). The surgery
removes skin cancer under local anaesthetic.
Sight and
sunlight
S
kin cancers usually present
as painless nodules, ulcers or
discoloured lesions on the skin.
Since sun damage - from its
harmful rays - is the most significant
risk factor, they tend to appear on the
exposed parts of the body; eyelids
are therefore a common site.
Fair-skinned individuals are most at risk
because their skin contains less melanin,
a pigment which limits damage from UV light.
Historically, non-melanoma skin cancer was
associated with advanced age, but as a result
of foreign travel, outdoor pursuits and the use of
sunbeds, skin cancer is presenting in progressively
younger people. Modifying behaviour in order
Exposed body parts, such as eyelids, are common sites of skin cancer
to reduce sunlight exposure and the daily use
of a sunscreen is recommended, especially for
those who work or spend a lot of time outdoors,
or have a history of skin cancer in their family.
Be vigilant
Growth, usually over a period of months, is
a key feature of skin cancer. Eventually the lesion
begins to crust or bleed following minor trauma.
Pigmented lesions may also become darker and
more irregular. Patients who experience these
symptoms are strongly advised to see their GP.
Target the tumour
The British Association of Dermatologists
recommends surgical excision as the treatment
'Treatment of skin cancer at an early stage
offers the best chance of complete cure'
Mohs surgery is also superior to conventional
excision in terms of conserving normal tissue,
thereby reducing the loss of vital structures
around the affected eye. The British
Association of Dermatologists recommends
Mohs surgery as the treatment of choice for
recurrent basal cell carcinoma (BCC) and
for the most aggressive type of BCC in the
eyelid area because of the higher cure rate
associated with the use of this technique.
Self-examination for skin lesions you believe
are suspicious is recommended, since
treatment of skin cancer at an early stage
offers the best chance of complete cure
and optimal functional and cosmetic results.
MEET THE
ExPErT
Miss Julia Sen
is a consultant
ophthalmologist at the
Worcestershire Acute NHS Trust
Specialising in eyelid and tear drainage
surgery, Miss Sen (pictured, above) has
a sub-specialist practice in periocular skin
cancer and reconstructive surgery.
She is a trained Mohs micrographic
surgeon and a core member of the
multidisciplinary skin cancer team.
Miss Sen is involved in undergraduate
teaching and has presented her
research at international meetings
and in peer reviewed journals.
FOR MORE INFORMATION
Call Spire Eye Centre, Southbank Hospital
on 01905 362033 or Optegra Birmingham
Eye Hospital on 0808 149 2666.
Left lower lid basal
cell carcinoma
Following Mohs
microsurgical excision
Post-operative result after
reconstructive surgery

Table of Contents for the Digital Edition of At Home Christian Jessen 2014

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