S. Tiwari, K. Gebauer
Basal cell carcinoma is the most commonly diagnosed can-cer and in most cases, can be successfully treated with sur-gical resection. In some patients, these cancers can reach alocally advanced state which is not amenable to surgery orradiation, or these cancers may rarely metastasize. Treat-ment options for these individuals with locally advanced ormetastatic basal cell carcinoma have until recently beenlimited. Basal cell carcinomas have been shown to demon-strate genetic alterations in hedgehog signaling pathwaycausing aberrant pathway activation resulting in uncon-trolled proliferation of basal cells. The development of thenovel hedgehog inhibitor Vismodegib has provided a newmanagement option for high risk patients – an alternativetreatment modality showing promising results. We discussour experience with the use of this agent in two patientsfrom a private dermatology practice in Perth. Both patientshad numerous basal cell carcinomas for which surgicalresection would have been challenging and cosmeticallydisadvantageous. We provide an up to date review and dis-cuss pertinent issues with regards to using Vismodegib rel-evant to the practicing dermatologist.