BCC + SCC Flashcards
Where are BCCs commonly found?
Sun exposed sights - especially head and neck
Growth of BCC? (Fast/slow)
Slow growing
Do BCC metastasise?
V V RARE!! They only locally invade
Presentation of BCC?
On head and neck
Pearly rolled edge, flesh-coloured papule with telangiectasia
May ulcerate - leave a central ‘crater’
Slowgrowing - may be present for years
RF for BCC?
UV exposure,
History of frequent or severe sunburn in childhood
Skin type 1
Increasing age
Male
Immunosuppressed
Previous Hx of skin cancer
FHx
What is referral process for BCC?
Routine referral
Management options for BCC?
Surgical excision
Mohs micrographic surgery
Radiotherapy
Cryotherapy
Curettage + cautery
Topical photodynamic therapy
Topical cream: imiquimod, fluorouracil
Complications of BCC?
Local tissue invasion and destruction
What is prognosis of BCC based on?
Tumour size
Site
Type
Histological subtype
Failure of previous treatments/recurrence
Immunosuppression
Morphological subtypes of BCC?
Nodular - most common
Superficial - plaque like
Cystic
Morphoeic
Keratotic
Pigemented
RF for SCC?
- excessive exposure to sunlight / psoralen UVA therapy
- actinic keratoses and Bowen’s disease
- immunosuppression e.g. following renal transplant, HIV
- smoking
- long-standing leg ulcers (Marjolin’s ulcer)
- genetic conditions e.g. xeroderma pigmentosum, oculocutaneous albinism
Presentation of SCC?
Keratotic (scaly or crusty)
Ill-defined nodule
May ulcerate
From passmed:
- typically on sun-exposed sites such as the head and neck or dorsum of the hands and arms
- rapidly expanding painless, ulcerate nodules
- may have a cauliflower-like appearance
- there may be areas of bleeding
Growth of SCC? (Fast/slow)
Fast (faster than BCC)
Do SCCs metastasise?
Yes - they have the potential to metastasise
Referral process for SCC?
2ww
Management for SCC?
Surgical excision
Mohs micrographic surgery may be used in high-risk patients and in sites that are cosmetically important
Surgical excision rules for SCC:
What is excision margin on SCC <20mm diameter?
4mm margin
Surgical excision rules for SCC:
What is excision margin on SCC >20mm diameter?
6mm margin
Characteristics of SCC with a good prognosis?
Well differentiated tumour
<20mm diameter
<2mm deep
No associated disease
Characteristics of SCC with a poor prognosis?
Poorly differentiated tumours
>20mm in diameter
>4mm deep
Immunosuppressed pt
What is it?
BCC
What is it?
SCC
What is it?
SCC
What is it?
BCC
Passmed: What type of skin cancer (BCC or SCC) is more common following immunosuppression e.g ciclosporin post renal transplant
SCC - higher risk
