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Merkel cell carcinoma is a rare but highly aggressive form of skin cancer that arises from Merkel cells, which are involved in touch sensation and located in the outer layer of the skin. This cancer typically develops on sun-exposed areas such as the face, neck, and arms, predominantly in older adults and individuals with weakened immune systems. Chronic ultraviolet exposure and infection with Merkel cell polyomavirus are major contributing factors.

Clinically, Merkel cell carcinoma presents as a rapidly growing, painless, firm, red or violet skin nodule. Because it can resemble benign skin lesions, early diagnosis is often challenging. Confirmation requires a skin biopsy with immunohistochemical analysis, followed by imaging studies to assess lymph node involvement and distant spread.

Management involves a multidisciplinary approach. Surgical excision with clear margins is the primary treatment for localized disease, often combined with radiation therapy to reduce recurrence risk. For advanced or metastatic cases, immunotherapy—particularly immune checkpoint inhibitors—has shown promising results. Due to its aggressive nature and high recurrence rate, close follow-up and surveillance are essential. Early detection and prompt treatment significantly improve outcomes and survival in patients with Merkel cell carcinoma.