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In Episode 64 of Derms and Conditions, our host, Dr James Q. Del Rosso sits down with Dr\nShane Chapman, Chair of the Department of Dermatology at Dartmouth Hitchcock Medical\nCenter, to discuss nonsurgical approaches to treating nonmelanoma skin cancer.\xa0\nDr. Chapman begins by discussing topical treatment options for nonmelanoma skin cancer for\npatients who are not candidates for surgery. He comments on the use of intralesional\nchemotherapy for keratoacanthomas or squamous cell carcinomas in poorly healing areas or\nwhen multiple lesions are present, compares the benefits of 5-fluorouracil and intralesional\nmethotrexate, and explains the benefits of using oral acitretin with intralesional therapy.\nThe pair then discuss intralesional methotrexate in more detail, explaining how methotrexate\nand 5-fluorouracil can be interchanged or used in combination with PDT to treat\nkeratoacanthomas/squamous cell carcinomas. They also discuss how to approach a case of a\npatient with a nodular basal cell carcinoma on her nasal tip who refuses treatment with surgery\nor radiation.\n\nNext, they discuss treatment of broader skin lesions, such as superficial or multifocal basal cell\ncarcinomas and detail imiquimod, 5-fluorouracil, and both red and blue light PDT as potential\ntreatment options.\n\nTo conclude, they discuss how to manage brisk imiquimod responses and the impact on\ntreatment duration. Tune into this episode to hear the full details and learn more!