New Frontiers in Skin Cancer Management

Across the spectrum of diagnosis, prognostication, prevention, and treatment, advances in technology and therapeutics are reshaping how clinicians care for patients with skin cancer. This issue highlights innovations and insights that are changing the field and offers a glimpse of where skin cancer management may be headed in the future.

One of the most exciting developments is the growing integration of artificial intelligence and molecular diagnostics into clinical practice. Dermatologists now have access to increasingly sophisticated tools that can support diagnosis at the clinical, dermatoscopic, and histologic levels. Gene expression profiling and other molecular technologies are helping clinicians better distinguish equivocal lesions, assess biologic behavior, and refine prognostic risk beyond traditional clinicopathologic features. These advances may ultimately help personalize management decisions, including determinations regarding which patients require more aggressive intervention and which may not.

Meanwhile, therapeutic options for skin cancer continue to expand dramatically. Advances in Mohs micrographic surgery, intralesional therapies, and immunotherapy are broadening treatment possibilities while offering opportunities to reduce morbidity and improve outcomes. The rapid evolution of immunotherapy, in particular, has transformed care for melanoma and advanced cutaneous malignancies. What began in the metastatic setting has now moved into neoadjuvant and adjuvant treatment strategies for melanoma and squamous cell carcinoma, with growing evidence supporting improved recurrence outcomes and opportunities for treatment de-escalation in select patients.

Innovations are also redefining the dermatologist’s role within multidisciplinary cancer care. As immunotherapy becomes increasingly integrated into earlier stages of disease and intralesional therapies continue to advance, dermatologists may become more directly involved in administering these treatments. The expanding field of dermatologic management of immunotherapy-related cutaneous toxicities also will only grow in relevance as checkpoint inhibitors are used more broadly across oncology.

Finally, we can never forget about prevention. The basics of early detection and sunscreen remain critical, but we now also have strong data indicating that nicotinamide (vitamin B₃) can help reduce risk, particularly of squamous cell carcinomas.

The articles in this issue provide clinically relevant, forward-looking perspectives. Our hope is that this will support dermatologists in delivering thoughtful, evidence-based care to patients facing skin cancer diagnoses.

— Laura K. Ferris, MD, PhD
Guest Medical Editor