27/11

Question 1

What decides whether or not a wide or narrow excision is done when removing a skin cancer?

What is done along with a wide excision?

Answer 1

Breslow’s thickness - a thickness >0.8mm = wide

Sentinel lymph node biopsy

Question 2

What clinical feature indicates if a skin cancer has grown deep?

Answer 2

Raised

If a cancer is raised it indicates that it is growing vertically

Question 3

Clinical features of BCC

Clinical features of SCC

How do you describe new skin lesions (non-pigmented)?

Answer 3

New skin lesions
- Location (set the scene)
- Well/poorly defined
- Irregular or regular border
- Raised or flat
- Ulceration/scale/crust

BCC
- pearly in light
- central ulceration (sometimes with crust) with a curled edge
- raised (but not always!)
- slow growing !!!
- telactasia

SCC
- scaly/crusty
- fast growing!!
- can be raised or flat

Question 4

What is the difference between scale and crust

Answer 4

Scale = dry skin that when it is picked off it will reveal intact skin underneath

Crust = dry skin that when picked off will reveal broken skin underneath

Question 5

What are the 2 precursors of SCC - how are they managed

What would make you think SCC?

Answer 5

Actintic keratosis
Bowen’s disease (SSC-in situ)

Both are scaly - Bowen’s is more erthymatous but rarer

Occasionally need biopsy to ensure not SCC

Cryotherapy
Imiquoid cream - get a big inflammation response for 6 weeks then slowly resolves - need reviewed again 12wks after

SCC? = thicker, growing, ulcerated, tender

Question 6

What is the name of the melanoma that occurs on the soles/palms/nail beds

Answer 6

Acral lentiginous