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The incidence rates of skin cancer in Australia are the highest in the world. In 2002 the age-standardised incident rate for basal cell carcinoma (BCC) was estimated to be 884 per 100,000 of the population. This rate showed a three-fold gradient between northern and southern Australia [1]. BCCs are the most common cutaneous tumours, accounting for approximately 70% of all malignant diseases of the skin. They are found predominantly on areas of skin exposed to the sun, particularly in fair skinned individuals. Up to 80% of all BCCs are found on the head and neck. They are more common in males, presumably related to occupational and recreational exposure to UV light. They tend to occur in older people [2]. In 2002 the age-standardised incidence of squamous cell carcinoma (SCC) was estimated to be 387 per 100,000 of the population with a significant latitude gradient (similar to BCCs). Also, as for BCCs, the incidence of SCCs increases with increasing age. The head and neck are the most common sites of occurrence for SCC in men, while upper limbs are the most common sites for women. When body surface area is taken into account the highest SCC incidence in both men and women is found on the face, especially the lips nose cheek eyelids and ears [3].  In general the surgical management of SCC is more radical than for BCC because SCCs are potentially more aggressive, have a greater potential for local recurrence and may spread to regional lymph nodes and distant sites. Over 70% of the BCCs in Australia were surgically excised [1]. The majority of SCCs were surgically excised [1]. In Australia about 400 people die from skin cancers other than melanoma each year. These are predominantly SCC but some deaths are due to BCC [1]. The recommended surgical margin of excision for SCC varies from 2 mm to 10 mm. Histological margins of 1 mm or less mandates consideration of further therapy [3]. The diameter of SCC correlates with risk of recurrence. Lesions thicker than 4 mm or extending to at least the reticular dermis are associated with a higher rate of recurrence. A higher risk of local recurrence includes the ear. The majority of clinically favourable SCCs of less than 2 cm can be excised with a margin of at least 4 mm [4].

A novel treatment for non-melanoma skin cancer of the ear: V to Y full thickness skin graft