INTRODUCTION: The incidence of skin cancer on the head and neck is increasing worldwide, and basal and squamous cell carcinomas represent the most frequent types. There is no unanimous consensus for all tumor cases, based on the histological type, size, depth, and location of the lesion. The objective is to analyzed the approach used in skin neoplasias in the head and neck, focusing on the treatments performed, recurrence, and follow-up.
METHODS: Sixty-nine patients with basal or squamous cell carcinoma who were treated with surgery, cryotherapy, freezing of lesions in the intraoperative period, or 5% imiquimod were analyzed for 6 weeks. During 36 months of follow-up, the efficacy of the chosen treatment, recurrence, side effects, complications, and esthetic satisfaction of patients were observed. Statistical analysis was performed using the Fisher's exact test.
RESULTS: The most frequent type of reconstruction was primary closure (71%). There were no statistically significant correlations between age, sex, Fitzpatrick classification, location/size of lesion, method of treatment, or recurrence. The main complications resulting from surgery were: a case of a frontal flap necrosis, a partial lesion of the buccinator nerve, and nasal stenosis. There was a 4% tumor recurrence in patients treated with surgery. The cryotherapy and 5% imiquimod treatments resulted in six cases of mild local reactions with a more pronounced recurrence in a patient with superficial basal cell carcinoma (BCC) (not statistically significant).
CONCLUSIONS: Non-superficial BCC and squamous cell carcinomas should be treated with surgery. Superficial BCCs may be treated with cryotherapy and 5% imiquimod with fewer complications and better aesthetic results, but this results in higher tumor recurrence.
Keywords: Skin neoplasias; Basal cell carcinoma; Squamous cell carcinoma; Post-operative complications.