In recent years, we have seen the introduction of several new therapies for metastatic skin cancer that have had a marked impact on the survival of our patients. These results have been accompanied by a growing interest in medical oncology for patients with skin cancer. This could increase further with the use of these drugs as adjuvant therapies, that is, for the treatment of patients who are at high risk but currently disease-free.

If dermatologists are to retain their leadership role in the management of skin cancer, they will have to acquire the tools they need to continue fulfilling this role. In this context, we applaud the AEDV's initiative in publishing Clinical Practice Guidelines (CPG) for the management of the main skin cancers. These guidelines review the available evidence in order to resolve the dilemmas that arise in the management of certain situations. They also include recommendations specifically adapted to the Spanish setting. This issue includes CPG on the diagnosis and treatment of Merkel cell carcinoma.1

In the case of Merkel cell carcinoma, CPG are particularly useful for 3 reasons: a dramatic increase in the incidence of this tumor due to the growth of the population at risk (as a result of aging of the population, exposure to UV radiation, and immunosuppression)2; the aggressive nature of the disease (with survival at 5 years of only 45% of patients diagnosed with a stage T1 tumor)3; and the fact that correct decisions in the initial stages of the disease can be vital in achieving a successful therapeutic outcome.