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Dermatology 101

Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is a rare, aggressive skin cancer that is at high risk of recurring and metastasizing throughout the body. About 2,500 new cases of MCC and about 700 deaths from it occur in the US each year, and that is expected to rise. Usually associated with a virus called the Merkel cell polyomavirus, MCCs are believed to begin in Merkel cells at the base of the epidermis. They most often arise on sun-exposed areas in fair-skinned individuals over age 50. These tumors usually appear as firm, painless lesions or nodules on a sun-exposed area (about half of the time on the head and neck, and frequently on the eyelids). They are typically red, blue, purple or skin-colored and vary in size, but average about 17mm in diameter (the size of a dime). MCCs are curable when detected and treated early. They can advance rapidly so early detection and treatment are crucial. MCC has a 20-70% chance of recurrence.
Treatments include wide local excision followed by adjuvant radiation therapy to decrease recurrence. For advanced disease, newly approved immunotherapy (Avelumab and Pembrolizumab) has increased overall survival.

Posted in: Dermatology 101

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