A new study published in Frontiers has tracked epithelial skin cancer across three distinct windows: before COVID-19, during the pandemic, and after it. The paper's central question is deceptively simple. Did pandemic-era disruptions in dermatologic access change how, and how late, these cancers were caught?

The cancers at issue are the epithelial group — the keratinocyte carcinomas, basal cell carcinoma and cutaneous squamous cell carcinoma, which together account for the bulk of skin malignancies diagnosed each year. These are not melanomas. But they are not trivial either. Advanced squamous cell carcinoma carries real metastatic risk, and treatment delays can widen excision margins, complicate reconstruction and raise costs.

Skin cancer screening depends heavily on in-person examination. That is the structural vulnerability the pandemic exposed.

What did lockdowns do to skin cancer detection?

When clinics closed and elective procedures paused in 2020, dermatology lost its main diagnostic pathway: the eyes of a clinician on a patient in a room. Telehealth filled some of the gap. Yet epidermal lesions that require dermoscopy, biopsy or palpation do not translate cleanly to a video call.

The Frontiers analysis sits within a now-substantial literature documenting what happened next across cancer care generally: fewer screening visits, fewer biopsies, fewer excisions during the acute disruption phase, followed by a rebound as services reopened. The editorial framing of the paper asks whether that rebound fully absorbed the backlog, or whether some patients surfaced later with more advanced disease.

That question matters most for squamous cell carcinoma, where delay has a clearer clinical cost.

Why timing matters for keratinocyte cancers

Basal cell carcinoma typically grows slowly and rarely metastasizes. A delay of months is, for most patients, unlikely to change outcomes materially. Squamous cell carcinoma behaves differently. Tumor size at diagnosis, depth of invasion and perineural involvement all feed into staging decisions, and all can worsen while a lesion waits for a biopsy slot.

The take-home for clinicians is straightforward: the pandemic's dermatologic aftershocks are still being measured, and this paper is part of that measurement effort.

What comes next?

Studies of this kind typically draw on registry or institutional pathology data, comparing diagnostic volumes and tumor characteristics across the pre-pandemic, pandemic and post-pandemic periods. Their value lies in hardening what clinicians suspected anecdotally into quantified trends — the kind that inform surge planning and telehealth triage policy if another disruption arrives.

The full analysis is available through Frontiers, and Derm Field will follow the data as post-pandemic surveillance cohorts mature.