In recent years there have been a number of interesting advances in several topics relating to the diagnosis and treatment of cutaneous lesions with particular applicability to primary and metastatic
malignancies of the scalp. In this article we provide a general update of advances in this field, and cover the more salient points relating to a variety of malignant
tumors that have been reported to appear on the scalp as primary or metastatic lesions. A search and review of the literature on PubMed was made to identify and discuss relevant points relating to diagnosis and treatment of primary and metastatic
tumors of the scalp. We describe the anatomy of the scalp, epidemiology of scalp
tumors, theories of field cancerization and field
therapy, photodynamic therapy, excisional surgical techniques and reconstruction, lymphoscintigraphy,
chemoprevention, as well as details relating to atypical fibroxanthoma,
Brooke-Spiegler syndrome,
nevus sebaceus, cutaneous
lymphoma, and metastatic disease. There is a very broad differential diagnosis for scalp nodules, which includes many different benign and malignant diseases, and treatment should be tailored accordingly. Given the potential for poor prognosis with some of the more aggressive
malignancies that can be found in this anatomic area, the importance of a thorough physical examination cannot be emphasized enough, and early detection is critical to provide patients with the best chance for a favorable outcome.