Contribution of dermatologic surgery in war.

ABSTRACT

BACKGROUND: Despite the large contribution by dermatology to military readiness, there have been no published reports regarding dermatologic surgery or skin cancer in the combat environment. OBJECTIVE: To outline the contribution of dermatologic surgery, including skin cancer and benign tumors, to deployed service men and women in Operation Iraqi Freedom. METHODS: A retrospective chart review was performed of all dermatology visits at the 86th Combat Support Hospital, Ibn Sina, Iraq, between January 15, 2008 and July 15, 2008. RESULTS: Two thousand six hundred ninety-six patients were seen in the combat dermatology clinic during the 6-month period reviewed; 8% (205/2,696) of the total visits were for skin cancer, and another 129 patients were treated for actinic keratosis. The specific diagnoses were basal cell carcinoma (n=70), in situ and invasive squamous cell carcinoma (n=68), mycosis fungoides (n=1), bowenoid papulosis (n=1), and in situ and invasive melanoma (n=9). Benign lesions and tumors accounted for 14% (357/2,696) of total patient visits. Three hundred seven surgeries were performed during the 6-month period (178 skin cancers and 129 benign lesions), and 20 patients were referred for Mohs micrographic surgery. The surgical complications included five postoperative wound infections (1 methicillin-resistant Staphylococcus aureus), one wound dehiscence, and seven allergic contact dermatitis. CONCLUSIONS: To the authors' knowledge, this is the first publication regarding skin cancer and dermatologic surgery in the combat setting. This report outlines the important contribution of dermatologic surgery in the combat environment.