The National Comprehensive Cancer Network (NCCN) updated their statement on how to manage non-melanoma skin cancer (NMSC) during this COVID-19 pandemic on March 30, 2020. This is how NOVA Plastic Surgery and Dermatology in Ashburn, Virginia will proceed with our patients with suspicious lesions unless further updates are made:
Currently, the NCCN is recommending that teleconferences should be used whenever possible in order to develop care plans for high-risk NMSCs, such as Merkel Cell Carcinoma (MCC.) These high-risk skin cancers require more than just simple office-based excisions and thus need to be considered on a case-by-case basis in order to properly utilize available resources and consider each patient’s risk factors. Merkel Cell Carcinomas are a very rare and very serious type of skin cancer. They are serious because they have a high rate of recurrence and metastasis. They are 40 times rarer than melanoma.
Teleconference with video is encouraged for the evaluation of new lesions/tumors whenever possible. Repeat follow-up teleconference with video and/or photographs are encouraged for small lesions that are suspected to be NMSC. At this time, it is recommended that biopsies be reserved for growing lesions or those that are highly concerning.
If it is determined that a biopsy is necessary, your provider at NOVA Dermatology will take photos with identifying body landmarks, such as tattoos or other moles, or have you re-mark the site daily in order to be able to accurately locate the lesion in case there is a delay in the biopsy or further treatment.
Biopsies are not considered the definitive treatment for skin cancer. They will ultimately need a full excision or other treatment, depending on the type of skin cancer. Since most excisions of NMSC (except for the MCC) are recommended to be postponed during this pandemic, it is important that you, as the patient, are able to help your provider locate the lesion again when excisions are finally allowed again. For NMSC that is at risk for metastasis or debilitating progression within 3 months, then excision may be considered.
If a patient develops a COVID-19 infection around the time of the biopsy or surgery, they may be at risk for unanticipated post-surgical complications. Self-Quarantine before and after surgery could help to reduce this risk. We will discuss a plan of care in advance of the procedure so you are aware of what signs and symptoms to look for of a post-surgical respiratory illness.
At NOVA Plastic Surgery and Dermatology we will be following all recommendations and taking extreme precautions to guarantee we are minimizing any spread of COVID-19 when you come into our office.
Ways to Minimize Spread of COVID-19 During an Office-Based Procedure
Screening Questions for COVID- 19
Do you have a suspicious lesion that you are worried may be skin cancer? Contact NOVA Plastic Surgery and Dermatology to make a virtual consultation or in-person appointment to be evaluated by our highly experienced Dermatology providers. Feel free to give our office a call at 703-574-2588 with any additional questions.