Dermatologist Discusses Personalized Approach to Skin Cancer Treatment

MedicalResearch.com Interview with:

Dr. Kristine A. Romine MD CEO and Founder of Camelback Dermatology & Skin Surgery Phoenix, AZ

Dr. Romine

Dr. Kristine A. Romine MD
CEO and Founder of Camelback Dermatology & Skin Surgery
Phoenix, AZ

MedicalResearch.com: Would you give a brief overview of the different types of skin cancer?

Response: There are multiple types of skin cancer, including: melanoma, basal cell carcinoma, squamous cell carcinoma, and actinic keratosis. Known as the deadliest form of skin cancer, melanoma develops when irreparable DNA damage results in malignant transformation of melanocytes. This type of skin cancer is most commonly caused by intense UV exposure from the sun or tanning beds, which activate mutations that lead skin cells to rapidly multiply and form malignant tumors. Melanoma can range in color from dark brown to black and are rarely red or even skin colored. They are usually irregular and asymmetrical. In 2018, there were an estimated 91,270 new cases of melanoma (American Cancer Society, 2018).

Basal cell carcinoma (BCC) is the most common type of skin cancer and cancer diagnosed. BCCs arise in the skins’ outermost layers. BCCs resemble open sores, red or pink plaques, pearly nodules with telangiectasia, or scars. It is estimated that 4.3 million BCCs are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018).

Squamous cell carcinoma (SCC), the second most common type of skin cancer, arises from the squamous cells in the skin that have been exposed to UV over long periods of time. SCCs appear as scaly red or pink macules, papules, or plaques. They can be crusted and appear eroded and can commonly arise within a solar keratosis. More than 1 million cases of SCC are diagnosed in the U.S. every year (Skin Cancer Foundation, 2018).

Lastly, actinic keratoses (AKs) are the most common pre-cancerous skin growth that can develop into a SCC if left untreated. Similar to all other types, AKs are caused by exposure to UV light and, in rare cases, high exposures to x-rays. AKs can appear on sun-exposed areas, including the face, scalp, ears, shoulders, and legs. They resemble pink, scaly rough patches on the skin.

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Medicare Spends Hundreds of Millions Annually to Treat Precancerous Skin Lesions

MedicalResearch.com Interview with:
“Actinic Keratosis” by Ed Uthman is licensed under CC BY 2.0Howa Yeung, MD
Assistant Professor of Dermatology
Emory University School of Medicine
Atlanta, GA 30322 

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by actinic keratoses?

Response: Actinic keratoses are common precancerous skin lesions caused by sun exposure. Because actinic keratoses may develop into skin cancers such as squamous cell carcinoma and basal cell carcinoma, they are often treated by various destructive methods. We used Medicare Part B billing claims to estimate the number and cost of treated actinic keratoses from 2007 to 2015.

MedicalResearch.com: What are the main findings? 

Response: While the number of Medicare Part B beneficiaries increased only moderately, the number of actinic keratoses treated by destruction rose from 29.7 million in 2007 to 35.6 million in 2015. Medicare paid an average annual amount of $413.1 million for actinic keratosis destruction from 2007 to 2015. Independently billing non-physician clinicians, including advanced practice registered nurses and physician assistants, are treating an increasing proportion of actinic keratosis, peaking at 13.5% in 2015.

MedicalResearch.com: What should readers take away from your report?

Response: Readers should understand that the burden of actinic keratosis treatment is increasing in the Medicare population. There is also an increasing proportion of actinic keratoses being treated by advanced practice registered nurses and physician assistants.  Continue reading