The following is a summary of “Periocular and ocular surface nonmelanoma skin cancer,” published in the February 2024 issue of Dermatology by Hooper, et al.
Periocular and ocular surface nonmelanoma malignancies, such as basal cell carcinoma (BCC), squamous cell carcinomas (SCC), and ocular surface squamous neoplasia (OSSN), are infrequent yet necessitate specialized management approaches. BCC ranks as the most prevalent periocular malignancy, constituting 80% to 96% of cases, followed by SCC, which accounts for 5% to 10% of cases. OSSN represents a spectrum of disorders involving dysplastic changes to the squamous epithelium of the eye, ranging from squamous dysplasia to conjunctival intraepithelial neoplasia/carcinoma in situ to invasive SCC, the most prevalent ocular malignancy.
Staging of these tumors can be accomplished using the eighth edition of the American Joint Committee on Cancer categorization system. Mohs micrographic surgery is the standard approach for periocular malignancies, while medical treatments like 5-fluorouracil (5-FU), interferon alfa-2b (INF), and mitomycin C (MMC), or “no-touch” surgical excision, are viable options for OSSN. Advanced disease may necessitate systemic therapies, including sonic hedgehog inhibitors for BCC, epidermal growth factor inhibitors, and immune checkpoint inhibitors for SCC.
Recurrence rates for periocular and ocular malignancies surpass those of their cutaneous counterparts. Additionally, the carcinomas and their respective treatments present unique side effects and considerations aimed at preserving visual function throughout the management process.
Reference: sciencedirect.com/science/article/abs/pii/S0738081X23001761