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The Study: Since surgery with wide margins is the treatment of choice for most non-melanoma skin cancers, patients who present with multiple lesions can be left up a creek. Dermatologists in the skin cancer capital of the USA (i.e., Miami) have tried their hands at harnessing the immune system for multifocal skin cancers. The thought is that the HPV vaccine has long been touted as effective primary prevention for HPV-driven cervical, anogenital and oropharyngeal cancers. Since basic science indicates HPV is involved in skin cancer development, it should be added to this list—as a report from this Miami group has already supported. So let’s move on therapeutic uses. Hey, if something as obscure as polio can be injected into the brain, injecting HPV into a skin cancer shouldn’t even raise an eyebrow. Well this case report has raised quite a few, particularly figure 1. A women with multiple basaloid squamous cell carcinomas (virtually incurable by conventional standards) is lo and behold cured with regular ole Gardasil vaccination plus intratumoral injections in her 3 largest lesions. Outlier? Maybe, maybe not. And, if not, it could change the face (and arms and legs and torso) of cutaneous oncology.
Bottom Line: Intratumoral HPV vaccines may prove to have a remarkable efficacy in some non-melanoma skin cancers. | Nichols, JAMA Dermatol 2018