Dr. Christine Cornejo points out highlights from her lecture "Merkel Cell Carcinoma: How I Do It" on Saturday, November 11, 2023, at the 4th Annual Elevate-Derm PA/NP Conference in Coachella Valley, CA.

In this video

In conversation with Derm PA Eileen Cheever, Dr. Cornejo outlines the three main drivers of Merkel cell carcinoma \exexposure. She notes that Merkel cell polyomavirus infection factors into at least half of patients, and shares the AEIOU mnemonic — Asymptomatic, Enlarging rapidly, Immunosuppressed, Older than 50, and Ultraviolet-exposed site — to help recognize lesions that can look "so nonspecific" at onset.

Because Merkel cell carcinoma carries a high risk of recurrence — with 90% of recurrences happening within the first two years — Dr. Cornejo describes the close five-year surveillance model used at Dana-Farber, including skin checks every three months, lymph node exams, imaging, and Merkel cell polyomavirus oncoprotein antibody testing. She emphasizes the community dermatology team's role in that follow-up: doing thorough skin checks, checking lymph nodes, and palpating the affected region since Merkel cell can be felt below the surface before it becomes prominent, and reaching out to specialists whenever something feels off.

  • Think of three main drivers for Merkel cell carcinoma: UV/sun exposure, Merkel cell polyomavirus infection, and immunosuppressed status.
  • Use the AEIOU mnemonic — Asymptomatic, Enlarging rapidly, Immunosuppressed, Older than 50, Ultraviolet-exposed site — since lesions can look nonspecific.
  • Expect a high risk of recurrence, with 90% recurring within the first two years, so early follow-up should be close — often every three months for the first couple of years across a five-year window.
  • Beyond full skin exams, check lymph nodes and palpate the region; Merkel cell may be felt under the skin and larger than it appears on the surface, aiding earlier detection of recurrence.
  • Community derm providers are part of the surveillance team — stay empowered to reach out to the treating specialist when something feels off.