The role of the dermatologist in diagnosing, managing advanced basal cell carcinoma

The authors currently do not recommend combining vismodegib therapy with surgery unless the tumor margins are very well defined clinically. [...]information about rates and histological patterns of recurrence - if any - after stopping vismodegib is published, partially excising histologically cleared skin does not seem logical. New oral Hedgehog pathway inhibitors, such as sonidegib, are currently undergoing trials and could potentially offer improved side effect profiles, increased efficacy or even decreased resistance potential.8 Potential hedgehog pathway inhibitors such as itraconazole and arsenic trioxide may play an important role in treatment of vismodegib resistant tumors.9 Additionally, topical smoothened inhibitors under current study may be useful in cases where oral vismodegib is not tolerated.10 Future articles in this series regarding aBCC will review the current state of research as well as the impact and management of aBCC in elderly patients.