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AAD introduces new guidelines for NMSC

murad_alam.jpg Christopher_Bichakjian.jpgBy Murad Alam, MD, and Christopher Bichakjian, MD
Co-chairs, NMSC Clinical Guidelines Workgroup

We are pleased to announce that the Academy has developed new guidelines for nonmelanoma skin cancer. These new evidence-based guidelines provide the most current information and recommendations for the surgical and medical treatment, follow-up, and prevention of BCC basal cell carcinoma (BCC) and cSCCcutaneous squamous cell carcinoma (cSCC).

The guidelines address the most commonly considered and utilized approaches for the surgical and medical treatment of primary BCC and cSCC, in addition:

  • Appropriate biopsy techniques.
  • Staging.
  • Follow-up.
  • Prevention of BCC/cSCC in skin cancer patients.
  • General approach to metastatic disease.

 JAAD-icon.png Access the full cSCC skin cancer guideline from JAAD
Access the full BCC skin cancer guideline from JAAD.


The guidelines also stress the importance of provider-patient dialogue for patients of all ages to select the most appropriate method to address the skin cancer based on available treatment options, recurrence rate, preservation of function, patient expectations, and potential adverse effects.

Highlights of the new guidelines include:

  • The guideline recommends the types of biopsies to determine a diagnosis of BCC and cSCC, with the goal of the biopsy to obtain needed clinical information to guide care.
  • Surgery remains the cornerstone of BCC and cSCC treatment.
  • Nonsurgical approaches (topicals, radiation, photodynamic therapy) have lower cure rates and should only be considered for low-risk BCC or cSCC if surgery is impractical or contraindicated.
  • As there are limited options to treat metastatic disease, early and complete treatment is important.
  • Patients diagnosed with BCC or cSCC should have annual checks for skin cancer recurrence or other new primary skin cancer(s).

The guidelines were created by a work group that included medical and surgical dermatologists from academic and private practice, pathologists and dermatopathologists, and a patient advocate. In addition, a multidisciplinary panel of invited reviewers was utilized to provide cross-specialty feedback on the guidelines.