Although the increasing incidence of skin cancer has concerned dermatologists for years, the true magnitude of this epidemic has recently come into focus. In 2006, more than 3.5 million new cases of nonmelanoma skin cancer were diagnosed in the United States, with the estimated cost of treatment in the Medicare population over $400 million dollars per year.1,2 In addition, large increases in skin cancer incidence were noted in Canada, Northern Ireland, Scotland, and the Netherlands. Given these trends, physicians treating skin cancer must identify tumors at low and high risk for recurrence and metastasis, and be familiar with available treatment options, including newer therapeutic alternatives. In this issue of Seminars in Cutaneous Medicine and Surgery, experts in the field focus on recent developments in cutaneous oncology, providing us with a comprehensive look at current and future trends affecting skin cancer patients and their physicians. As the number of patients affected by skin cancer continues to increase, efforts to prevent ultraviolet (UV) radiation-induced tumors have intensified. New chemopreventive agents targeting stages of skin cancer development, or reversing UV-induced immune suppression, are being extensively studied. When used in conjunction with traditional sunscreens, these agents may provide enhanced protection against the harmful effects of UV radiation. Drs Camp and Elmets provide a framework for understanding how these agents work and under what circumstances they could prove most useful. Another hot topic is whether lasers or topical treatments can effectively treat nonmelanoma skin cancer, thereby providing an alternative to the more traditional modalities of surgery and radiation. Drs Brightman, Warycha, Anolik, and Geronemus review the data regarding these alternative strategies, which could benefit patients who have numerous small, superficial tumors, or who are reluctant to undergo surgery. To optimize patient care, it is critical to identify skin cancer patients at risk for poor outcomes and standardize the classification, staging, and treatment of high-risk tumors. Drs LeBoeuf and Schmults summarize the National Comprehensive Cancer Network’s treatment guidelines for classification and management of high risk cutaneous squamus cell carcinoma, as well as the American Joint Committee on Cancer staging guidelines. The development of reliable prognostic models and validated staging systems for this tumor will facilitate the design of clinical studies and will ultimately guide future treatment decisions for affected patients. The most common post-transplant malignancy for immunosuppressed organ transplant recipients is skin cancer. Drs Singh and Brewer review the management alternatives for organ transplant recipients affected by skin cancer, including surgery, adjuvant radiation, and chemotherapy, as well as options for chemoprophylaxis and reduction of immunosuppression. Also addressed are special considerations, including the approach to patients with regional and distant metastatic disease, and management issues in patients with multiple primary nonmelanoma skin cancers and melanoma. Merkel cell carcinoma is an unusual, aggressive cutaneous tumor, seen more frequently in immunosuppressed patients, whose incidence is also increasing. It was recently found to be associated with a novel doublestranded DNA virus, the Merkel cell polyoma virus, a discovery that has sparked great interest in viral tumorigenesis. Drs Wang, Byrne, Jacobs, and Taube discuss new developments in the diagnosis, staging, and management of Merkel cell carcinoma , and provide an update on current thinking regarding the pathogenesis of this rare tumor. An increasingly attractive option for patients with aggressive or advanced nonmelanoma skin cancer is targeted molecular therapy. The new generation of targeted molecular inhibitors provides hope for a subpopulation of patients with advanced skin cancer, potentially enhancing their quality of life as well as their life expectancy. Drs O’Bryan and Ratner provide an overview of recent developments and future possibilities for treatment of unresectable or metastatic squamous cell carcinoma, basal cell carcinoma, and dermatfibrosarcoma protuberans. We are grateful to the authors for sharing their expertise and knowledge with us for this special issue. It is through educational, clinical, and research efforts like theirs that the morbidity, mortality, and cost of the skin cancer epidemic will eventually be mitigated.