dermatooncology

Dermato-oncology is a medical subspecialty that concentrates on cancers of the skin and related malignant conditions. It combines principles from dermatology and medical oncology to diagnose, stage, treat, and prevent skin cancers and other malignant skin disorders. Clinicians in dermato-oncology work within multidisciplinary teams that may include dermatologists, surgical oncologists, radiation oncologists, pathologists, radiologists, and medical oncologists.

Common diseases include cutaneous malignant melanoma, basal cell carcinoma, squamous cell carcinoma, and Merkel cell carcinoma. The field also addresses other skin cancers such as cutaneous T-cell lymphomas, Kaposi sarcoma, cutaneous metastases from internal cancers, and high-risk pre-malignant lesions such as actinic keratoses and dysplastic nevi. Rare pediatric tumors may also be encountered.

Diagnosis and staging rely on history, clinical examination, dermoscopy, and histopathologic confirmation from skin biopsy. Staging may incorporate imaging and sentinel lymph node biopsy for melanoma. Molecular profiling and immunohistochemistry aid in diagnosis and therapeutic decisions. Risk factors include ultraviolet exposure, fair skin, family history, and genetic syndromes.

Treatment is usually multimodal and tailored to tumor type and stage. It can include surgical excision, Mohs micrographic surgery, lymphadenectomy, radiotherapy, topical or photodynamic therapies, and systemic therapies. Systemic options include targeted therapies for melanoma with BRAF mutations (with MEK inhibitors) and immunotherapies such as PD-1/PD-L1 and CTLA-4 inhibitors. For non-melanoma skin cancers, hedgehog inhibitors, radiotherapy, and skin-directed therapies are used as appropriate. Management emphasizes minimizing morbidity and preserving function and appearance.

Research in dermato-oncology focuses on early detection, molecular pathways, biomarkers, and the development of immunotherapies and targeted treatments. Guidelines and registries support standardized care, while survivorship and quality-of-life considerations are integral to practice.