Quantum Dots for Margin Visualization in Non-Melanoma Skin Cancers: Advances in Nanotechnology for Cutaneous Surgical Precision

Background: Non-melanoma skin cancers, including basal cell carcinoma and squamous cell carcinoma, are the most prevalent malignancies worldwide. Achieving histologically clear margins is critical for recurrence prevention, yet conventional techniques often fall short in precision and real-time intraoperative guidance. Objective: To evaluate quantum dots as emerging nanotechnology platforms for surgical margin visualization in NMSC, highlighting their physicochemical properties, targeting strategies, imaging modalities, safety profiles, and translational barriers. Methods: A comprehensive review of literature from 2011 to 2025 was conducted, encompassing quantum dot design, bioconjugation techniques, tumor-targeting ligands, imaging integration with dermatoscopes and microscopy, and preclinical/ clinical applications in cutaneous oncology. Results: Quantum dot-based systems offer unprecedented spatial resolution (as low as 20–100 µm) for tumor margin delineation due to their exceptional brightness, photostability, and multiplexing capability. Functionalized quantum dots targeting biomarkers such as EGFR and integrins (αvβ3, αvβ6) demonstrate tumor-specific accumulation both in vivo and ex vivo. Comparative studies show that quantum dots outperform traditional dyes like ICG in photostability and specificity. Biodegradable alternatives, including carbon, silicon, and CuInSe-based quantum dots, are mitigating toxicity concerns. Integration with time-gated imaging, AI-assisted classification, and real-time surgical guidance systems further enhances clinical utility. Conclusion: Quantum dots represent a transformative innovation in the precision resection of non-melanoma skin cancers. While challenges remain in safety, delivery, and regulatory approval, ongoing advancements in biocompatibility and intelligent imaging integration position quantum dots as pivotal tools for the next generation of fluorescence-guided dermatologic surgery.