This chapter contains material  that is not ‘core’ to the main purpose of skincancer909, but may be of interest to some medical students (and others). I also include some suggestions for further reading for those wishing to go more than skin deep.

Learning more: suggestions for further reading

Skincancer909 is aimed at medical students, and emphasises the intersection of fundamental science and clinical skills. It is not written at a level that you would expect of a doctor treating patients with skin cancer. I hope (and know) that others have found it useful, and in this spirit, I list some suggestions for those wishing to delve deeper. My links to other texts and the research literature is slightly idiosyncratic, and is biased to those areas of the subject I have worked on. You are warned.

What follows is somewhat personal, as I have provided links to things that I have found useful or are interested in. In one sense the goal of skincancer909 was to provide you with all that you need to know — but thank heavens for awkward students who like to plough their own furrow.


Textbooks of dermatology

A good heavily illustrated textbook of all of dermatology (not just skin cancer) is:

Bolognia: Dermatology, by Jean L. Bolognia MD,‎ Julie V. Schaffer MD,‎ Lorenzo Cerroni. It provides coverage of some basic skin biology, and curiously I do not know of a better general overview of the skin biology relevant to dermatology, although I wish somebody would write one.

There are two shorter textbooks that are well worth a look, even if they are very much written as day-to-day manuals for dermatology residents. There are both wonderfully illustrated.

Fitzpatrick’s colour atlas and synopsis, by Klaus Wolff,‎ Richard Allen Johnson,‎ Arturo Saavedra,‎ Ellen Roh

Dermatology Essentials (also by Bolognia and colleagues) by Jean L. Bolognia MD,‎ Julie V. Schaffer MD,‎ Karynne O. Duncan MD,‎ Christine J. Ko MD

For a textbook on Skin Cancer only, I have found the following very useful, although it needs updating:

Cancer of the Skin: Expert Consult – Online and Print, 2e Hardcover – 26 Jul 2011 by Eggert Stockfleth MD PhD (Author),‎ Darrell S. Rigel MD (Editor),‎ June K. Robinson MD (Editor),‎ Merrick I. Ross MD (Editor),‎ & 4 more

Both Bolognia texts and the ‘Cancer of the skin’ text work really well on iPads. I have not tried the Fitzpatrick book on the iPad.


I am not a lover of guidelines, but the following are there if you beg to differ. In dermatology I still would prefer to be treated by a wise and experienced clinician, rather than a checkbox-heavy imposter. In any case it keeps people off the streets.

European Dermatology Foundation

NIHCE information on skin cancer

BAD guidelines and patient information sheets


Links to the primary literature

Epidemiology of NMSC

Two nice papers, that I have partially based some of the text from are:

Incidence and Trends of Cutaneous Malignancies in the Netherlands, 1989–2005. Cynthia Holterhues, Esther de Vries, Marieke W. Louwman, Senada Koljenovic and Tamar Nijsten. Journal of Investigative Dermatology (2010) 130, 1807–1812; doi:10.1038/jid.2010.58; published online 25 March 2010. (Link)

Trends in Basal Cell Carcinoma Incidence Rates: A 37-Year Dutch Observational Study. Sophie C. Flohil, Inge Seubring, Michelle M. van Rossum, Jan-Willem W. Coebergh, Esther de Vries and Tamar Nijsten. Journal of Investigative Dermatology (2013) 133, 913–918; doi:10.1038/jid.2012.431; published online 29 November 2012 (Link)

Puzzles about melanoma

The melanomas: a synthesis of epidemiological, clinical, histopathological, genetic, and biological aspects, supporting distinct subtypes, causal pathways, and cells of origin. David C. Whiteman, William J. Pavan and Boris C. Bastian. Pigment Cell Melanoma Res. 24; 879–897 (Link

This is a wonderful paper that raises all sorts of important issues about what we know — and what we don’t know — about melanoma pathogenesis. It is perhaps hard going, but worth it 🙂

Clinical reasoning and the basis of expertise

Geoff Norman has written well — very well — on this topic. Here are some links to nice papers of his:

The Non-Analytical Basis of Clinical Reasoning: Norman, G.R. & Brooks, L.R. Adv Health Sci Educ Theory Pract (1997) 2: 173. (Link)

Norman, G., Young, M. and Brooks, L. (2007), Non-analytical models of clinical reasoning: the role of experience. Medical Education, 41: 1140–1145. doi:10.1111/j.1365-2923.2007.02914.x (Link)

The best overview of this whole field I know of, is:

The Cambridge Handbook of Expertise and Expert Performance. ed K Anders Ericcson et al. (Link) (this is the second edition, I have only looked at the first edition).

Some papers from my own (more parochial) work on the ABCD and diagnostic ability in dermatology are here, here and here.

Pigmentation genetics

I worked for many years on pigmentation genetics and my lab (along with Ian Jackson and Tony Thody) identified the gene for red hair. the original Nature Genetics paper is here; the first two papers pointing out the relevance to skin cancer here (melanoma) and here (non-melanoma). A summary of the evolutionary population genetics of human pigmentation written with Rosalind Harding is here. If you are fascinated by genetics and human evolution, here are a few links to interesting recent papers to bring you up to speed (here and here).

Cancer genetics

If you (like me) have been fascinated by the power of the mutational theory of cancer (not just of the skin) here are a few pointers:

Tomasetti, C. & Vogelstein, B. Variation in cancer risk among tissues can be explained by the number of stem cell divisions. Science 347, 78–81 (2015) Link

High burden and pervasive positive selection of somatic mutations in normal human skin. Iñigo Martincorena et al. Link

Substantial contribution of extrinsic risk factors to cancer development. Song Wu, Scott Powers, Wei Zhu & Yusuf A. Hannun Link

The Path to Cancer — Three Strikes and You’re Out. Bert Vogelstein, M.D., and Kenneth W. Kinzler, Ph.D. Link

Detection and localization of surgically resectable cancers with a multi-analyte blood test. Joshua D. Cohen et al Link.

Automated diagnosis (do we still need humans?)

This recent paper from Sebastian Thrun and colleagues in Nature rightly attracted lots of attention. I wrote a little piece about it, with the strikingly unoriginal title: Software is Eating the Clinic. Cognitive prostheses will happen in this domain of medicine.

Some of the full text papers off my work on skin cancer over the years you can find here.

Some other stuff

Botulinum toxin is not a treatment for  skin cancer, but the video below is, I hope, a useful way to remind you of some of the relevant anatomy for any surgical intervention on the face. It is however, optional.

Skincancer909 by Jonathan Rees is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Where different rights apply for any figures, this is indicated  in the text.